Cases reported "Surgical Wound Infection"

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1/7. 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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keywords = phacoemulsification
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2/7. 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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3/7. 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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4/7. 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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5/7. Recurrent methicillin-resistant staphylococcus aureus wound ulcer after clear-cornea cataract surgery.

    PURPOSE: To present a case of recurrent, methicillin-resistant staphylococcus aureus (MRSA) wound ulcer after clear-cornea cataract surgery. methods: Case report. RESULTS: An 82-year-old man underwent an uncomplicated phacoemulsification procedure with posterior-chamber intraocular lens (PCIOL) implantation. Two weeks after surgery, a corneal ulcer was present at the wound site. Corneal tissue sample cultures produced methicillin-resistant staphylococcus aureus. The ulcer responded to high-dose vancomycin but recurred twice as vancomycin was tapered. Lamellar keratectomy with conjunctival flap was performed at 6 months after surgery, with no additional ulcer recurrence. CONCLUSIONS: wound infection after clear-cornea cataract surgery occurs infrequently. Management of these infections, however, can provide challenging clinical decisions.
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ranking = 1
keywords = phacoemulsification
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6/7. mycobacterium chelonae-Mycobacterium abscessus complex clear corneal wound infection with recurrent hypopyon and perforation after phacoemulsification and intraocular lens implantation.

    We report a clear corneal wound infection occurring in a 74-year-old man caused by a member of the mycobacterium chelonae-Mycobacterium abscessus complex, presenting as crystalline keratopathy with recurrent hypopyon. This led to perforation after phacoemulsification with posterior chamber intraocular lens implantation. Only after corneal biopsy of the incision was the causative organism isolated and found to be sensitive to clarithromycin and ciprofloxacin. Despite aggressive therapy, a full-thickness corneal perforation developed, requiring emergent cyanoacrylate glue to preserve ocular integrity. Both the difficulty and delays in obtaining a correct diagnosis led to severe ocular morbidity. Infectious lamellar keratitis limited to the clear cornea phacoemulsification incision is rare, but some unusual organisms such as atypical mycobacteria may be encountered.
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ranking = 6
keywords = phacoemulsification
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7/7. Spectrum of clear corneal incision cataract wound infection.

    PURPOSE: To describe the presentation, management, and outcome of 5 patients who presented with main-port or side-port wound infection after uneventful clear corneal cataract surgery. SETTING: Ophthalmic Surgery Centre, Chatswood, and Department of ophthalmology, Prince of wales Hospital, Randwick, australia, and Moorfields eye Hospital NHS Foundation trust, london, United Kingdom. methods: This retrospective case series comprised 5 patients who had uneventful clear corneal phacoemulsification surgery and developed either a main-port or side-port wound infection. The clinical features, microbiologic studies, management, and results are reported. RESULTS: The median age of the patients was 79 years. Infection of the main-port incision occurred in 3 cases and of the side port in 2 cases. The patients presented from a few days to several weeks after uneventful phacoemulsification. In 2 cases, the bacteria pseudomonas aeruginosa and Staphylococcus aureus were isolated. In 1 case, the fungus aspergillus was isolated and required extensive medical and surgical treatment. In the other 2 cases; empiric antimicrobial therapy was given because no organism was isolated in 1 case, and in the other milder case, microbiological investigations were not performed. Final visual acuity was 6/4 in 2 cases and 6/5, 6/12, and 6/18 in 1 case each. CONCLUSIONS: Bacterial or fungal wound infection can present within days or even several weeks following clear corneal cataract surgery. patients with ocular discomfort or blurred vision after such surgery should be advised to report promptly. Rapid identification and appropriate management of patients with clear corneal wound infection can result in good visual outcomes.
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ranking = 2
keywords = phacoemulsification
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