Cases reported "Endophthalmitis"

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1/36. pseudomonas aeruginosa endophthalmitis caused by contamination of the internal fluid pathways of a phacoemulsifier.

    PURPOSE: To report 4 cases of pseudomonas aeruginosa endophthalmitis caused by internal contamination of the internal pathways of a phacoemulsifier. SETTING: ophthalmology Center, Perpignan, france. methods: Four clinical cases of postoperative endophthalmitis occurred after phacoemulsification. An investigation was necessary to prove the cause of the bacteriological contamination. RESULTS: serotyping and ribotyping of the pseudomonas aeruginosa strains obtained from the vitreous samples and from the phacoemulsifier showed that all these strains were identical and that the initial site of the contamination was the phacoemulsifier. CONCLUSIONS: The profession should be cognizant of this cause of endophthalmitis, although its occurrence is rare. Cataract surgeons should test samples from the collection bags of their phacoemulsifiers to ensure there is no bacteriological contamination.
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ranking = 1
keywords = phacoemulsification
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2/36. vitrectomy and intraocular gentamicin management of Herellea endophthalmitis after incomplete phacoemulsification.

    A patient with Herellea endophthalmitis after incomplete phacoemulsification was treated with vitrectomy and intravitreal infusion of 8 mug/ml of gentamicin and 400 mug of dexamethasone. The vitrectomies were done through a pars plana incision with the vitrophage. Additionally, appropriate systemic antibiotics and prednisone were given.
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ranking = 5
keywords = phacoemulsification
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3/36. 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.
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ranking = 1
keywords = phacoemulsification
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4/36. 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.
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ranking = 1
keywords = phacoemulsification
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5/36. nocardia endophthalmitis following uncomplicated phacoemulsification and implantation of a posterior chamber intraocular lens.

    A patient developed endophthalmitis 15 days after uncomplicated cataract extraction. Excised infectious material sequestered in the capsular bag revealed nocardia on culture. She required multiple intravitreal injections of amikacin and dexamethasone, pars plana vitrectomies with explantation of the lens, and chronic topical and oral sulfonamide antibiotics to control the infection. Clinicians should also consider nocardia when the suspicion of fungal endophthalmitis is entertained, as nocardia are resistant to antifungals, but respond to intravitreal amikacin and chronic topical and oral sulfonamides.
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ranking = 4
keywords = phacoemulsification
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6/36. exophiala werneckii endophthalmitis following cartaract surgery in an immunocompetent individual.

    A case of infectious endophthalmitis caused by the saprophyte exophiala werneckii is reported. This has not been recognized as a pathogen for ocular infections previously. The infection followed uncomplicated cataract surgery involving phacoemulsification and IOL implant. Clinical presentation was that of an indolent endophthalmitis with relatively acute onset. Pars plana vitrectomy, fungal stains, and culture established the diagnosis. Initial management consisted of empirical intravitreal injection of vancomycin, ceftazidime, and amphotericin b. Treatment was supplemented with a 3-week course of systemic fluconazole and topical therapy with natamycin, atropine, ciprofloxacin, and diclofenac. The visual acuity returned to 20/20-2 with no recurrence of infection. The source of the infection could not be determined. Fungal endophthalmitis has to be considered as a rare, though important, complication following ophthalmic surgery. Specific fungal stains and cultures are helpful for establishing the diagnosis early in the course of disease. E werneckii should be considered in the differential diagnosis of fungal endophthalmitis.
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ranking = 1
keywords = phacoemulsification
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7/36. Endogenous amoebic endophthalmitis.

    A 42-year-old man experienced abrupt reduction of vision in the left eye and had vitreous opacity and hypopyon on initial examination. He underwent an emergency vitrectomy and phacoemulsification with posterior capsulectomy, followed by a 2-week course of intravenous fluconazole and antibiotics. The final visual acuity was 20/20 OS. Amoebas, together with polymorphonuclear cells, were observed on examination of specimens of the aqueous humor and vitreous fluid obtained during the surgery. staphylococcus epidermidis was also cultured from the vitreous fluid. The amoebas had a crescent-shaped periphery of the cytoplasm and ambiguous nuclei. Ultrastructurally, the cytoplasm was surrounded by a thick electron-dense coating. The early vitrectomy and combined use of antibiotics and antifungals might have led to the good visual outcome in this patient.
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ranking = 1
keywords = phacoemulsification
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8/36. Micrococcal endophthalmitis following extracapsular cataract extraction with foldable silicone intraocular lens implantation.

    A case of postoperative endophthalmitis caused by micrococci, after phacoemulsification and foldable silicone intraocular lens (IOL) implantation is reported.
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ranking = 1
keywords = phacoemulsification
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9/36. Translimbal approach for intravitreal injection in endophthalmitis after phacoemulsification.

    We describe a corneal limbal technique of intravitreal injection for use in cases in which it is difficult to confirm the position of the needle. Using this translimbal approach, the needle's position is easily identified and the intravitreal injection can be given using topical anesthesia. This technique is an option in eyes with a cloudy cornea or a large iridectomy.
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ranking = 4
keywords = phacoemulsification
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10/36. Delayed-onset postoperative endophthalmitis caused by hafnia alvei.

    PURPOSE: To identify hafnia alvei as an etiological factor of delayed-onset endophthalmitis. CASE REPORT: A 68-year-old woman had uneventful cataract extraction by phacoemulsification with foldable posterior chamber intraocular lens implantation under topical anesthesia in the left eye. Four weeks later, the patient presented anterior uveitis treated by topical corticosteroids. Seven weeks later a posterior uveitis with retinal vasculitis appeared. The patient was treated by systemic and intravitreal corticosteroids without result. Due to the poor course pars plana vitrectomy was done, and a vitreous sample was taken. Microbiologic examination disclosed hafnia alvei, gram-negative bacteria rarely isolated from human specimens. CONCLUSIONS: hafnia alvei should be considered in the etiology of delayed-onset endophthalmitis.
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ranking = 1
keywords = phacoemulsification
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