Culture Proven Endogenous Bacterial Endophthalmitis in Apparently Healthy Individuals
Culture Proven Endogenous Bacterial Endophthalmitis in Apparently Healthy Individuals
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DOI：
10.3109/09273940903216891
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发表时间：
2009-12-01
影响因子：
3.3
通讯作者：
Narayan, Shah Dev
中科院分区：
文献类型：
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作者：
Shankar, Khanal;Gyanendra, Lamichhane;Narayan, Shah Dev
目的：报告经培养证实的内源性眼内炎患者7例7眼。虽然在以前发表的大多数系列中，内源性眼内炎患者存在一个或多个易感因素，但作者提出了一个病例系列，这些患者明显健康且具有免疫能力，经培养证实为内源性眼内炎。设计：回顾性非对比病例系列。所有患者均为玻璃体培养阳性的内源性细菌性眼内炎。结果：肺炎链球菌占43%(3/7眼)，其次为金黄色葡萄球菌和大肠埃希菌各占29%(2/7眼)。从出现症状到出现眼内炎到住院的中位时间为7天。除1例视力为20/200外，其余病例视力均低于HM(手运动)。在所有病例中都没有发现单一的潜在诱因。所有病例均给予玻璃体内治疗药物(一剂或多剂抗生素和类固醇)，2例行玻璃体切除。除1例最终视力为20/40外，其余视力均不好于现有视力。眼压偏低(平均眼压为7 mm Hg，对侧眼为12 mm Hg)。无一例眼球摘除或摘除。结论：虽然在以前发表的大多数文献中，内源性眼内炎是一种转移性眼部感染，但本研究描述了一系列新发的内源性细菌性眼内炎，没有任何可识别的易感因素。与之前发表的系列相比，总体呈现年龄更年轻。总体视觉效果不佳，可能是由于疾病本身的严重性质和相对较晚的表现。
Purpose: To report 7 eyes of 7 patients who were diagnosed as the cases of endogenous endophthalmitis and proved by culture reports. Though in most of the previously published series, one or more predisposing factors were present in the patients of endogenous endophthalmitis, the authors are presenting a case series of culture-proven endogenous endophthalmitis in apparently healthy and immunocompetent individuals.Design: Retrospective noncomparative case series. All patients were diagnosed as endogenous bacterial endophthalmitis with positive vitreal culture. Variables studied were demographic characteristics, microbiology, therapeutic interventions done, final visual and anatomical outcome.Results: Streptococcus pneumoniae was the most frequent isolate 43% (3 out of 7 eyes) followed by Staphylococcus aureus and E. coli in equal frequency 29% ( 2 each out of 7 eyes). The median time between the onset of symptoms and presentation with features of endophthalmitis to hospital was 7 days. The presenting visual acuity was less than HM (hand motions) in all cases except one, which had VA of 20/200. No single underlying predisposing condition was identifiable in any of the cases. All the cases were given intravitreal therapeutic agents (one or more doses of antibiotics and steroid) and pars plana vitrectomy was performed in 2 cases. The final visual acuity was not better than presenting VA except in 1 case, which had final VA of 20/40. Intraocular pressure was on the lower side (mean IOP 7 mmHg compared to 12 mmHg in the fellow eye). No eye was enucleated or eviscerated.Conclusion: Though in most of the previously published literature endogenous endophthalmitis has been a metastatic ocular infection, the present study describes a series of endogenous bacterial endophthalmitis de novo in onset, without any identifiable predisposing factors. The overall age of presentation was in a younger population than in previously published series. The overall visual outcome was poor, probably due to the serious nature of disease itself and the relatively late presentation.