1/63. Infectious crystalline keratopathy and endophthalmitis secondary to mycobacterium abscessus in a monocular patient with stevens-johnson syndrome.PURPOSE: To describe the clinical and laboratory features of infectious crystalline keratopathy and endophthalmitis secondary to mycobacterium abscessus in a patient with stevens-johnson syndrome. METHOD: Case report. A 19-year-old man with a history of stevens-johnson syndrome and multiple corneal transplants developed white crystalline corneal infiltrates. RESULTS: anterior chamber aspirate disclosed acid-fast bacilli. A repeat corneal transplant was performed and antibiotic therapy begun. Histopathology showed focal acute inflammation surrounding collections of acid-fast bacilli, which were speciated as M. abscessus. CONCLUSIONS: M. abscessus is a cause of infectious crystalline keratopathy and endophthalmitis. risk factors include ocular surface disease, corneal transplantation, and immunosuppressive therapy.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/63. Late infection of hydroxyapatite orbital implants.BACKGROUND: Exposure and minor complications of hydroxyapatite orbital implants are common. infection appears to be rare and fibrovascular ingrowth into hydroxyapatite implants may make infection and extrusion less likely than with other types of orbital implant. methods: We describe three cases of chronic low-grade infection of hydroxyapatite implants, occurring late after apparently uncomplicated surgery, with tiny or inapparent areas of conjunctival loss or exposure. RESULTS: Two of the three cases grew Staphylococcus oureus on culture. All three implants ultimately needed to be removed. A characteristic histological pattern was seen, with abrupt transition between vascularized and abscessed implant. CONCLUSIONS: Chronic infection of hydroxyapatite implants can occur late, in the absence of large conjunctival defects, or other obvious risk factors.While exposure of the implant to pathogens through a breach in the conjunctiva may have been a factor, it appeared that the infection may have arisen in an avascular portion of the implant prior to the conjunctival breakdown in one or more of these cases.- - - - - - - - - - ranking = 0.14285714285714keywords = abscess (Clic here for more details about this article) |
3/63. Staphylococcal infection under a LASIK flap.PURPOSE: To report a staphylococcal infection under a laser in situ keratomileusis (LASIK) flap and to discuss the management of this rare and potentially devastating complication. methods: A patient was referred to our practice having had bilateral LASIK. She was found to have abscesses under the left corneal flap. staphylococcus aureus was identified as the infecting organism by corneal scrape and treated with appropriate antibiotics. The cornea improved, and then the abscess recurred. The abscess was again scraped and intensive treatment reinstituted. RESULTS: After successful treatment, the patient recovered excellent visual acuity with only a minimal astigmatic error. CONCLUSION: The possible reasons for the apparent improvement and then recurrence of the abscess are discussed. The management of this case including the need for corneal scrape and antibiotic prophylaxis is discussed in relation to previously reported cases.- - - - - - - - - - ranking = 0.57142857142857keywords = abscess (Clic here for more details about this article) |
4/63. haemophilus influenzae associated scleritis.AIMS: To describe the clinical course and treatment of haemophilus influenzae associated scleritis. methods: Retrospective case series. RESULTS: Three patients developed scleritis associated with ocular H influenzae infection. Past medical history, review of systems, and laboratory testing for underlying collagen vascular disorders were negative in two patients. One patient had arthritis associated with an antinuclear antibody titre of 1:160 and a Westergren erythrocyte sedimentation rate of 83 mm in the first hour. Each patient had ocular surgery more than 6 months before developing scleritis. Two had cataract extraction and one had strabismus surgery. Nodular abscesses associated with areas of scleral necrosis were present in each case. culture of these abscesses revealed H influenzae in all patients. Treatments included topical, subconjunctival, and systemic antibiotics. Scleral inflammation resolved and visual acuity improved in each case. CONCLUSION: H influenzae infection may be associated with scleritis. Accurate diagnosis and treatment may preserve ocular integrity and good visual acuity.- - - - - - - - - - ranking = 0.28571428571429keywords = abscess (Clic here for more details about this article) |
5/63. Preseptal cellulitis secondary to proteus species: a case report and review.BACKGROUND: Preseptal cellulitis is a serious ocular condition that--if left untreated--has the potential to cross the septal barrier, spread to the posterior orbit, and may result in fatal complications. Because it is difficult to determine the pathogen responsible for any cellulitis without aspirating a culture sample, treatment is usually instituted by an assumption of the most common causative organisms, Staphylococcus or streptococcus. CASE REPORT: A 42-year-old black woman manifested signs and symptoms consistent with right preseptal cellulitis. Throughout treatment, visual acuity remained 20/20 for both eyes, extraocular muscles were unrestricted without pain, and anterior globe structures were clear. The patient was started on a regimen of 250-mg oral dicloxacillin four times a day. When no response was seen at 36 hours, the patient was changed to 500-mg oral ciprofloxacin every 12 hours. She responded to the 500-mg ciprofloxacin and recovered with no sequelae. An abscess, which had formed during the cellulitis, self expressed and this material was cultured. The cultures identified the responsible organism as proteus species, an unexpected pathogen in a well-groomed patient. CONCLUSION: This case demonstrates the need to consider alternate pathogens when treating preseptal cellulitis, change medications accordingly, and consider alternate treatments as needed.- - - - - - - - - - ranking = 0.14285714285714keywords = abscess (Clic here for more details about this article) |
6/63. Small, overlapping tectonic keratoplasty involving graft-host junction of penetrating keratoplasty.PURPOSE: To report the indications for and postoperative course of small tectonic keratoplasties overlapping (and involving) the graft-host junction of preexisting penetrating keratoplasties. methods: A retrospective study of 15 consecutive eyes (15 patients) with small tectonic keratoplasties overlapping the graft-host junction of preexisting penetrating keratoplasties. RESULTS: After tectonic keratoplasty, follow-up times ranged from 5 months to 20 years (mean, 69 months). Clinical indications included sterile corneal ulceration (seven cases), bacterial keratitis (six cases), and fungal keratitis (two cases). In the six cases with bacterial keratitis, five were suture abscesses, with four resulting in wound dehiscence. Ten tectonic grafts were lamellar keratoplasties, and five were penetrating keratoplasties. Postoperative best-corrected visual acuities were unchanged from preoperative levels in every patient. After tectonic grafting, the mean /- SD change in keratometric astigmatism in the parent penetrating keratoplasty was 1.75 /- 1.50 diopters. The astigmatism increased in 10 cases, decreased in three, and remained unchanged in two. There was no case of recurrent ulceration or wound dehiscence in or around the tectonic grafts. The surgery did not result in new glaucoma or worsening of preexisting glaucoma. CONCLUSIONS: In the treatment of infectious or ulcerative foci at or near the graft-host junction of penetrating keratoplasties, a small extirpative, tectonic graft over the diseased junction appears to be a safe and effective alternative to either repeating the original penetrating keratoplasty or performing an oversize transplant.- - - - - - - - - - ranking = 0.14285714285714keywords = abscess (Clic here for more details about this article) |
7/63. A devastating ocular pathogen: beta-streptococcus Group G.PURPOSE: To report the clinical findings, treatment, and outcomes of four cases of beta-streptococcus Group G (BHS-G) ocular infection. methods: The medical and microbiologic records of four cases of BHS-G ocular infection were retrospectively reviewed. RESULTS: Two cases of BHS-G endophthalmitis and two cases of BHS-G keratitis were recorded. Three patients developed fulminant infection within 12 hours of the onset of symptoms. One patient's history was incomplete. One patient developed endophthalmitis from a contaminated donor button; another following cataract surgery. One developed keratitis in a keratoplasty suture tract; and another patient developed a corneal abscess after being struck with a tree branch. The patient with the contaminated donor button developed overwhelming endophthalmitis resulting in no light perception vision, severe pain, and evisceration. The postoperative cataract patient developed a purulent endophthalmitis and is still hypotonus with light perception vision. The second keratitis patient developed a significant suture abscess with marked stromal loss but eventually healed. The traumatic keratitis patient developed a large ulcer with hypopyon and descemetocele but was lost to follow-up. CONCLUSIONS: This is the first report of a series of BHS-G ocular infections. The ocular infections were characterized by rapid onset, extreme inflammation, and--despite in vitro antibiotic sensitivity--a poor or sluggish response to antibiotic therapy.- - - - - - - - - - ranking = 0.28571428571429keywords = abscess (Clic here for more details about this article) |
8/63. Bacterial subretinal abscess: a case report and review of the literature.PURPOSE: To report a case of klebsiella subretinal abscess with a successful visual outcome with treatment and to review the literature pertaining to focal intraocular infection in bacterial endophthalmitis. methods: Clinical data including medical history, findings on physical examination, blood cultures, and an abdominal computed tomographic scan were collected in a 32-year-old man with klebsiella sepsis, liver abscesses, and a focal subretinal abscess. Ocular data including visual acuity, fundus photographs, fluorescein angiography, and ultrasound were evaluated, as were results of culture and histopathologic studies. RESULTS: Despite immediate intervention, including vitreous tap and intravitreal antibiotics, the eye deteriorated, with enlargement of the abscess. A pars plana vitrectomy was performed in which the subretinal abscess material was removed after an extensive retinectomy of the involved area in association with an endophotocoagulative barrier and intravitreal amikacin without gas or oil tamponade. culture confirmed klebsiella subretinal infection. A retinal detachment occurred 1 month postoperatively and was successfully repaired. visual acuity was 20/30 and has remained stable for 14 months. CONCLUSION: klebsiella endophthalmitis with subretinal abscess formation is a rare but devastating ocular condition. In the present case, prompt intervention with extensive retinectomy, complete abscess excision, and intravitreal antibiotic therapy resulted in unprecedented visual recovery.- - - - - - - - - - ranking = 1.5714285714286keywords = abscess (Clic here for more details about this article) |
9/63. Preseptal abscess formation following ocular cryotherapy for Behcet's uveitis.A 42-year-old man with Behcet's disease developed a rapidly growing mass under his right lower eyelid a week after transconjunctival cryotherapy. He underwent surgical drainage of the mass following imaging studies. magnetic resonance imaging scans demonstrated the abscess, which did not violate the orbital septum. Cultures from drained material yielded staphylococcus aureus. He recovered completely with systemic antibiotics. Preseptal abscess may occur as a complication of intense transconjunctival cryotherapy for intraocular disorders, and patients should be followed closely within the first few weeks postoperatively.- - - - - - - - - - ranking = 0.85714285714286keywords = abscess (Clic here for more details about this article) |
10/63. Orbital abscess masquerading as a rhabdomyosarcoma.Although orbital cellulitis is the most common cause of acute-onset proptosis with inflammatory signs in a child, the clinician should always be alert to the possibility of rhabdomyosarcoma. We describe an unusual presentation of acute-onset nonaxial proptosis of the left orbit without sinus disease or systemic toxicity in a 6-year-old boy. Our clinical differential diagnosis included orbital cellulitis, metastatic disease, capillary haemangioma, lymphangioma with cyst, ruptured dermoid cyst, and orbital rhabdomyosarcoma. Only after orbital biopsy and subsequent microbiologic confirmation were obtained was a diagnosis of chronic orbital abscess tenable. Features in our patient included paucity of symptoms and signs of inflammation. This case illustrates the difficulty in differentiating a chronic orbital infection from orbital rhabdomyosarcoma on the basis of clinical, laboratory, and orbital imaging findings. Possible causes of this unusual presentation are discussed.- - - - - - - - - - ranking = 0.71428571428571keywords = abscess (Clic here for more details about this article) |
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