Cases reported "Eye Infections, Bacterial"

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1/26. 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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2/26. 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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3/26. 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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4/26. 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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5/26. 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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keywords = phacoemulsification
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6/26. 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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7/26. 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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8/26. 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.
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ranking = 1
keywords = phacoemulsification
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9/26. Acute postoperative endophthalmitis caused by actinomyces neuii.

    PURPOSE: To describe a case of acute postoperative endophthalmitis caused by actinomyces neuii after uncomplicated phacoemulsification with posterior chamber intraocular lens implant. methods: Interventional case report. A 58-year-old male underwent phacoemulsification, right eye, with posterior chamber intraocular lens implant. On postoperative day 6, he presented with pain, redness, and decreased visual acuity, right eye, and was found to have endophthalmitis. RESULTS: Vitreous cultures revealed the gram-positive, anaerobe actinomyces neuii. After appropriate intraocular, periocular, topical, and systemic therapy, the infection cleared, but the vision of the patient never improved as a result of a central vein occlusion. CONCLUSION: actinomyces species can rarely cause postoperative endophthalmitis, and it should be considered in cases of severe postoperative intraocular inflammation.
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ranking = 2
keywords = phacoemulsification
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10/26. corneal ulcer of the side port after phacoemulsification induced by acinetobacter baumannii.

    A 75-year-old man had clear corneal phacoemulsification using a temporal approach in the left eye. Two months after surgery, a focal corneal epithelial defect developed with infiltration near the lower limbus on the site of the side-port incision. The culture of corneal scrapping grew acinetobacter baumannii, which is resistant to most ordinary antibiotics in sensitivity tests. After appropriate antibiotic treatment, the ulcer healed gradually with vessel ingrowth. acinetobacter baumannii is usually found in nosocomial infection of immune-compromised patients in the intensive care unit. It is a rare pathogen of infectious keratitis. Our case, with its unusual infection site, may point to potential risk factors for this pathogen.
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ranking = 5
keywords = phacoemulsification
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