Cases reported "Endophthalmitis"

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1/222. A case of bacterial endophthalmitis following perforating injury caused by a cat claw.

    A case of bacterial endophthalmitis following a perforating ocular injury caused by a cat claw is reported. The scleral wound was sutured immediately following the injury and systemic antibiotics were administered. Despite this treatment, endophthalmitis occurred 3 days after the injury. The endophthalmitis was resolved by pars plana vitrectomy, however preretinal reproliferation and retinal detachment subsequently occurred. After reoperation the retina was reattached and the corrected visual acuity improved from 10 cm/HM to 20/200. pseudomonas aeruginosa was detected in cultured vitreous humor that was collected during surgery. This case illustrates the possibility of endophthalmitis being caused by gram negative bacillus in cases of perforating injuries caused by animal claws. Perforating ocular injuries caused by animal claws are relatively rare. Here we report a case of endophthalmitis due to pseudomonas aeruginosa that occurred after a perforating injury caused by a cat claw. The eye was treated by pars plana vitrectomy.
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2/222. Endogenous endophthalmitis associated with bacillus cereus bacteremia in a cocaine addict.

    A 22-year-old black female intravenous cocaine addict presented with an endophthalmitis of the right eye. Diagnostic evaluation included an immediate anterior chamber paracentesis and a delayed vitreous aspiration. Although cultures from the involved eye were negative, all 7 blood cultures grew Bacillus cereus suggesting that this organism was the responsible agent of an endogenous endophthalmitis. The patient was treated with appropriate systemic and local antibiotics with resolution of the acute inflammatory signs. However, a phthisical eye has been noted on follow-up examinations.
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3/222. Post-traumatic endophthalmitis: causative organisms and visual outcome.

    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 /- 11 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.
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keywords = culture
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4/222. aspergillus fumigatus endophthalmitis in a patient with acute myeloid leukaemia.

    A 55-year-old patient developed progressive loss of vision in one eye following induction chemotherapy for acute myeloid leukaemia (AML). aspergillus fumigatus was cultured from vitreal aspirates. The patient was treated with intravenous and intravitreal amphotericin b but suffered complete loss of vision in her right eye. We believe this is the first report of culture-proven aspergillus fumigatus endophthalmitis in a patient treated for a haematological malignancy.
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ranking = 2
keywords = culture
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5/222. Use of a low nutrient culture medium for the identification of bacteria causing severe ocular infection.

    A low nutrient culture medium was used to identify the pathogens in four cases of persisting ocular infection. Bacto R2A agar was used in addition to conventional liquid- and solid-phase media to culture pathogenic bacteria from one case of recurrent keratitis, one case of suture-related keratitis with endophthalmitis and two eyes (two patients) with post-operative endophthalmitis. In each case, a pathogen was identified solely with R2A agar after culture for 6 days. Species isolated were pseudomonas aeruginosa (one), propionibacterium acnes (two) and staphylococcus aureus (one). Antibiotic therapy was tailored to conform to the sensitivity of the cultured organism in each case. The use of Bacto R2A low nutrient agar should be considered in culture negative eyes not showing clinical improvement, or for chronic cases where bacteria may have become adapted to more stringent ocular environments.
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ranking = 9
keywords = culture
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6/222. serratia marcescens renal abscess with endophthalmitis: a case report.

    A renal abscess, caused by serratia marcescens with endophthalmitis in a 68-year-old diabetic female, is described. endophthalmitis presented with visual loss, conjunctiva injection and lid edema with eye pain. Right costovertebral knocking pain was also noted. Sonography and computed tomography of abdomen showed a 4 cm hypoechoic lesion in the middle portion of the right kidney with marginal enhancement after contrast media injection. Percutaneous abscess drain was performed. Pus culture from the drain tube revealed S. marcescens, yet, vitreous cultures yielded no growth, which was ascribed to previous antibiotics use. Although vitrectomy, fortified eye drops, intravitreal and systemic intravenous antibiotics were administered, the visual function was still lost. To our knowledge, this is the first reported case of S. marcescens renal abscess complicated with endophthalmitis.
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keywords = culture
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7/222. Serious infections from Bacillus sp.

    Serious infections caused by organisms of the genus Bacillus developed in seven patients. Five drug abusers had either endocarditis or osteomyelitis, one leukemic patient had necrotizing fasciitis, and one patient had a ventriculoatrial shunt infection with recurrent bacteremia. All patients recovered. Experience with these cases reemphasizes the importance of not dismissing Bacillus organisms as culture contaminants, especially when isolated from blood, body fluids, or closed-space infections.
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ranking = 1
keywords = culture
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8/222. endophthalmitis from mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for bladder carcinoma.

    PURPOSE: To present clinical and histologic findings of intraocular infection with mycobacterium bovis-bacille Calmette-Guerin after intravesicular bacille Calmette-Guerin injections for treatment of bladder carcinoma. methods: A 77-year-old man was initially seen with visual acuity of 20/200, focal retinitis, vasculitis, and progressive vitreous opacity in the right eye and visual acuity of light perception, intraocular inflammation, and a dense cataract in the left eye 14 months after intravesicular injection of live bacille Calmette-Guerin organisms. RESULTS: Vitreous cultures in the right eye demonstrated growth of bacille Calmette-Guerin organisms. Bilateral loss of light perception occurred despite systemic antimy-cobacterial therapy. Histopathologic examination demonstrated nongranulomatous inflammation and acid-fast bacilli in both eyes. CONCLUSION: Delayed endogenous endophthalmitis may develop after intravesicular bacille Calmette-Guerin injection that may not respond to systemic agents. Intravitreal therapy may be indicated.
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9/222. exophiala jeanselmei causing late endophthalmitis after cataract surgery.

    PURPOSE: To report two cases of late endophthalmitis caused by exophiala jeanselmei after cataract surgery. methods: case reports, including clinical evaluation, direct examination, and culture of the aqueous humor. RESULTS: In each case, samples from the anterior chamber had positive growth of yeasts with toruloid hyphae and pseudohyphae. Intravitreal and anterior chamber amphotericin B were used in both cases. Apparent clinical resolution was achieved, but after 3 months in one case and 6 months in the other the infection recurred more aggressively, with severe endophthalmitis leading to ocular atrophy. CONCLUSION: E. jeanselmei causes a severe intraocular infection and isolation, and identification of the agent ensures proper diagnosis and treatment. After clinical resolution of the infection, careful and long-term follow-up is recommended to promptly detect relapse and immediately reintroduce treatment.
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keywords = culture
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10/222. Bilateral consecutive central corneal perforations associated with hypogammaglobulinemia.

    OBJECTIVE: To describe the presentation and the clinical course of a patient with consecutive central sterile corneal perforations associated with common variable immunodeficiency. DESIGN: Case report. methods: Multiple corneal cultures and scrapings were performed in an effort to identify an infectious cause and all were negative. Corneal biopsy did not demonstrate any evidence of micro-organisms. An extended investigation failed to uncover a collagen vascular cause or atopy. RESULTS: Progressive sterile stromal thinning with intact epithelium in the left eye proceeded to perforation despite topical treatment, and cyanoacrylate gluing was performed. However, a secondary haemophilus influenza endophthalmitis developed, and the eye was eventually lost. The fellow eye proceeded along the same clinical course with sterile stromal thinning. A lamellar patch graft was performed when the central ulceration progressed to a descemetocele. The eye remained quiet with 20/25 vision for 2 years, until the patient died from complications of a liver transplant. CONCLUSIONS: Devastating central sterile corneal thinning leading to perforation may occur in patients with hypogammaglobulinemia.
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