Post-traumatic endophthalmitis: causative organisms and visual outcome
Post-traumatic endophthalmitis: causative organisms and visual outcome
复制标题
DOI：
10.1177/112067219900900104
复制
发表时间：
1999-01-01
影响因子：
1.7
通讯作者：
Al-Obeidan, S
中科院分区：
文献类型：
--
作者：
Abu El-Asrar, AM;Al-Amro, SA;Al-Obeidan, S
目的。外伤后眼内炎是眼内感染的一个独特的亚类。本研究的目的是确定穿透伤眼感染性眼内炎后的致病微生物并记录视觉结果。方法。我们回顾了连续 18 例在穿透性眼外伤后出现的培养阳性眼内炎病例。所有病例均接受平坦部玻璃体切除术以及静脉和眼内抗生素治疗。结果。 15 名男性和 3 名女性的年龄从 4 岁到 43 岁不等（平均 25.1 +/- II 岁）。九人（50%）有眼内异物。 16 例中分离出单一物种，2 例中分离出多种生物。表皮葡萄球菌和革兰氏阴性菌是最常见的，单独培养或与其他微生物联合培养，分别有 5 例（27.7%）和 4 例（22.2%）。 3 例（16.6%）分离出产气荚膜梭菌。未发现芽孢杆菌是眼内炎的原因。 8 例 (44%) 的最终视力优于 20/400。在五例（27.7%）中，眼睛保住了，但视力只能数手指。两只眼睛（11%）没有光感。其余三只眼睛（16.6%）被摘除或取出内脏。从两只眼睛中分离出产气荚膜梭菌，从一只眼睛中分离出黑曲霉。术后出现视网膜脱离4只眼，均手术成功。结论。本系列分离的微生物与之前世界其他地区外伤后眼内炎报道中分离的微生物相似，只是产气荚膜梭菌分离频率较高且未培养出芽孢杆菌属。鉴于其破坏性后果，外伤后眼内炎必须立即通过玻璃体切除术和玻璃体内注射抗生素进行治疗。
Purpose. Post-traumatic endophthalmitis makes up a distinct subset of intraocular infections. The purpose of the present study was to identify the causative organisms and record the visual outcome after infectious endophthalmitis in eyes with penetrating trauma.Methods. We reviewed 18 consecutive cases of culture-positive endophthalmitis that developed after penetrating ocular trauma. All cases were treated with pars plana vitrectomy and intravenous and intraocular antibiotics.Results. The 15 males and 3 females ranged in age from 4 to 43 years (mean 25.1 +/- II years). Nine (50%) had intraocular foreign bodies. A single species was isolated in 16 cases, and multiple organisms in two. Staphylococcus epidermidis and gram-negative organisms were the most frequent and were cultured either alone or in association with other organisms in respectively five (27.7%) and four cases (22.2%). Clostridium perfringens was isolated in three cases (16.6%). Bacillus was not found as a cause of endophthalmitis. Final visual acuity was better than 20/400 in eight cases (44%). In five cases (27.7%), the eye was saved but visual acuity was counting fingers. Two eyes (11%) had no light perception. The remaining three eyes (16.6%) were enucleated or eviscerated. Clostridium perfringens was isolated from two eyes and Aspergillus niger from one. Postoperative retinal detachment developed in four eyes, which were successfully operated.Conclusions. Organisms isolated in this series were similar to those in previous reports of post-traumatic endophthalmitis from other parts of the world, except that the frequency of Clostridium perfringens isolation was high and no Bacillus species were cultured. In view of its devastating outcome, post-traumatic endophthalmitis must be treated promptly with vitrectomy and intravitreal antibiotics.