1/34. alcaligenes xylosoxidans and propionibacterium acnes postoperative endophthalmitis in a pseudophakic eye.PURPOSE: To report a case of persistent polymicrobial postoperative endophthalmitis caused by alcaligenes xylosoxidans and propionibacterium acnes in a pseudophakic eye. A. xylosoxidans is a gram-negative bacteria resistant to most antibiotics. methods: Case report. RESULTS: A 72-year-old man presented with clinical signs of endophthalmitis on the first postoperative day after a phacoemulsification procedure with posterior chamber intraocular lens, left eye. Initial treatment included topical, subconjunctival, and oral antibiotics. After initial clearing, there was recrudescence of infection on postoperative day 37 that prompted referral of the patient to the Cullen eye Institute. Treatment at that time included anterior chamber and vitreous taps with intravitreal antibiotic injections. Complete pars plana vitrectomy and intraocular lens explantation were eventually required because of persistent infection with a resistant organism. Cultures from the first procedure grew A. xylosoxidans and P. acnes. Cultures from the vitrectomy grew only A. xylosoxidans. At the final follow-up visit 6 months after the initial procedure. The eye was without inflammation with best-corrected visual acuity of 20/40. CONCLUSION: Both A. xylosoxidans and P. acnes can cause chronic progressive endophthalmitis after cataract extraction often resistant to corrective antibiotic therapy. Successful intervention may require complete vitrectomy with intraocular lens and capsule removal.- - - - - - - - - - ranking = 1keywords = eye, ocular (Clic here for more details about this article) |
2/34. propionibacterium acnes endophthalmitis requiring intraocular lens removal after failure of medical therapy.A 52-year-old Saudi man developed intraocular inflammation 7 weeks after uneventful phacoemulsification with implantation of a silicone posterior chamber intraocular lens (IOL). Cultures from the aqueous and vitreous were repeatedly negative, but a temporary response to intracameral and intravitreal injection of vancomycin was noted. A series of 6 intraocular injections given over 5 days failed to resolve the inflammation. It did, however, disappear after the IOL was removed. The IOL provided the only positive culture in this case of propionibacterium acnes endophthalmitis. Nine months later, a posterior chamber poly(methyl methacrylate) IOL was implanted. Eighteen months later, the patient had no recurrences. He regained a visual acuity of 20/30, corresponding to his best postoperative result.- - - - - - - - - - ranking = 0.53442542280234keywords = ocular (Clic here for more details about this article) |
3/34. Acute bilateral postoperative endophthalmitis in a HLA-DQ5-positive patient: possible susceptibility to infections.An unusual case of bilateral acute endophthalmitis in association with the HLA-DQ5 histocompatibility antigen is reported. A 35-year-old woman with high myopia and cataracts in both eyes underwent phacoemulsification procedures performed in separate sessions using different viscoelastic substances and following the same strict prophylactic measures. After each surgical procedure, she developed S. epidermidis acute endophthalmitis in the right eye and propionibacterium acnes acute endophthalmitis in the left eye; both were successfully treated with capsular bag irrigation and intracameral vancomycin (1 mg/0.1 mL). She tested positive for the HLA-DQ5 (DQ1), DQ2 antigen. The question is raised as to whether the HLA-DQ5 histocompatibility antigen may be a predisposing factor for both staphylococcal and P. Acnes acute endophthalmitis. A multicenter prospective study is proposed to identify this HLA antigen in all patients scheduled for cataract surgery who have a history of postoperative endophthalmitis in the fellow eye.- - - - - - - - - - ranking = 0.44054887604841keywords = eye (Clic here for more details about this article) |
4/34. optic disk edema as a presentation of propionibacterium acnes endophthalmitis.PURPOSE: To report a patient with an initial presentation of optic disk edema secondary to propionibacterium acnes endophthalmitis. methods: Interventional case report. The patient had surgery and treatment related to endophthalmitis. Nine months after cataract surgery with posterior chamber lens implant, a 79-year-old man receiving topical corticosteroids in the same eye presented with best-corrected visual acuity of 20/60, a superior visual field defect, and optic nerve edema without intraocular inflammation. One year postoperatively, the eye presented a further decrease in best-corrected visual acuity, and a dense white plaque was noted on the posterior capsule. RESULTS: One year postoperatively, a partial capsulectomy with vitrectomy and injection of intravitreal antibiotics was performed. hematoxylin and eosin stain of the posterior capsule plaque revealed gram-positive coccobacilli characteristic of P. acnes. CONCLUSION: propionibacterium acnes endophthalmitis may present after cataract surgery with intraocular lens implant with decreased vision, optic disk edema, and a visual field defect.- - - - - - - - - - ranking = 0.37296741596773keywords = eye, ocular (Clic here for more details about this article) |
5/34. gemella haemolysans keratitis and consecutive endophthalmitis.PURPOSE: To report a case of gemella hemolysans keratitis with consecutive endophthalmitis. methods: Interventional case report. A 47-year-old woman with a history of sarcoidosis treated chronically with systemic prednisone developed bacterial keratitis and consecutive endophthalmitis in the left eye. RESULTS: Corneal, aqueous, and vitreous cultures yielded G. hemolysans. Emergent keratoplasty, pars plana vitrectomy, and injection of intravitreal antibiotics led to resolution of the infection and improved vision. Five months after surgery, the corneal graft has remained clear since cessation of antibiotics. CONCLUSION: This is the first report, to our knowledge, of ocular G. hemolysans infection, an uncommon gram-positive pathogen often confused with viridans-type streptococci.- - - - - - - - - - ranking = 0.18648370798386keywords = eye, ocular (Clic here for more details about this article) |
6/34. propionibacterium acnes endophthalmitis in Ahmed glaucoma valve.PURPOSE: To report a case of propionibacterium acnes endophthalmitis in a patient with an Ahmed glaucoma valve. CASE REPORT: A nine-year-old boy with bilateral congenital glaucoma, with an Ahmed glaucoma valve implanted in the left eye, had recurrent conjunctival dehiscence and endophthalmitis. RESULTS: Vitreous cultures demonstrated the presence of propionibacterium acnes. CONCLUSIONS: This is the first reported case of propionibacterium acnes endophthalmitis in an Ahmed glaucoma valve and the second one in a glaucoma drainage device. We strongly recommend using a patch graft to prevent and treat tube exposure. Conjunctival grafts may be useful to close the conjunctiva when there is marked scarring to prevent patch exposure and melting or extrusion.- - - - - - - - - - ranking = 0.1101372190121keywords = eye (Clic here for more details about this article) |
7/34. Bilateral endogenous endophthalmitis associated with infective endocarditis: case report.Bilateral endogenous endophthalmitis is a rare condition initiated by infection by microbes in the bloodstream, such as those arising from a foci of infective endocarditis. We report a case and discuss the diagnostic aspects and the clinical outcome of a patient with characteristic findings of the disease. The patient was a 49 year old white male who had a metallic aortic valve implanted 7 months previously, and who presented to the hospital with 10 days of fever, cough and dyspnea, then diarrhea and mental confusion. On the second day of hospitalization, he experienced sudden loss of vision in both eyes. A Gram-positive coccobacillus was isolated from the bloodstream, he was treated with fluoroquinolone with disappearance of fever, decreased ocular inflammation, and improvement in his vision to light perception. He later underwent valve replacement surgery but died during the procedure. We review the occurrence of ocular signs and symptoms and their importance in patients with endocarditis.- - - - - - - - - - ranking = 0.26283019695563keywords = eye, ocular (Clic here for more details about this article) |
8/34. Successful treatment of orthodontic-associated traumatic endophthalmitis.PURPOSE: To report successful management of orthodontic-associated traumatic endophthalmitis. DESIGN: Interventional case report. methods: A 17-year-old boy developed endophthalmitis after a penetrating corneal injury produced during removal of an orthodontic wire. Treatment included pars plana vitrectomy (PPV) with broad-spectrum intravitreal and systemic antibiotics. RESULTS: Clinical endophthalmitis resolved after PPV with injection of intravitreal vancomycin (1 mg) and ceftazidime (2.25 mg), along with oral ciprofloxacin (750 mg twice daily). Microbiologic cultures of intraocular samples produced staphylococcus epidermidis, streptococcus viridans, and lactobacillus species. visual acuity improved to 20/20. CONCLUSIONS: Orthodontic-associated endophthalmitis can involve multiple organisms. It can be successfully treated with current treatment modalities, including PPV, intravitreal antibiotics, and systemic antibiotics.- - - - - - - - - - ranking = 0.076346488971762keywords = ocular (Clic here for more details about this article) |
9/34. Facial necrotizing fasciitis following acute dacryocystitis.PURPOSE: To report a case of progressive necrotizing fasciitis of the face following acute dacryocystitis. DESIGN: Interventional case report. methods: A 60-year-old woman presented with left acute dacryocystitis with abscess formation that had ruptured; a small wound remained. Erythematous swelling of the left eyelid and face developed 3 days later. Clinical progression and computed tomographic findings led to the diagnosis of necrotizing fasciitis with abscess formation. Early intravenous antibiotics and repeated surgical debridements were performed. RESULTS:Soft tissue necrosis was found the fascial planes extending deep to the maxilla bone and periorbital fat. The patient was successfully treated without ocular, orbital, or facial complications. CONCLUSIONS: Necrotizing fasciitis of the eyelid and face progresses rapidly. early diagnosis, prompt intravenous antibiotic administration, and aggressive surgical debridement will prevent the associated morbidity and mortality.- - - - - - - - - - ranking = 0.29662092699597keywords = eye, ocular (Clic here for more details about this article) |
10/34. Chronic postoperative endophthalmitis caused by propionibacterium acnes.Persistent intraocular inflammation after cataract surgery with intraocular lens implantation is acquiring importance. Frequently, chronic uveitis or the "toxic lens syndrome" have to be differentiated from bacterial infection. This report describes five cases with chronic postoperative endophthalmitis where the anaerobic bacterium propionibacterium acnes was found to be the causative organism. Adequate anaerobic culture media and proper sampling from the area around the lens haptics are the most important requirements for the detection of P. acnes.- - - - - - - - - - ranking = 0.15269297794352keywords = ocular (Clic here for more details about this article) |
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