Cause Of Endogenous Endophthalmitis Research Articles

Fungal and Parasitic Infections of the Eye

SUMMARYThe unique structure of the human eye as well as exposure of the eye directly to the environment renders it vulnerable to a number of uncommon infectious diseases caused by fungi and parasites. Host defenses directed against these microorganisms, once anatomical barriers are breached, are often insufficient to prevent loss of vision. Therefore, the timely identification and treatment of the involved microorganisms are paramount. The anatomy of the eye and its surrounding structures is presented with an emphasis upon the association of the anatomy with specific infection of fungi and parasites. For example, filamentous fungal infections of the eye are usually due to penetrating trauma by objects contaminated by vegetable matter of the cornea or globe or, by extension, of infection from adjacent paranasal sinuses. Fungal endophthalmitis and chorioretinitis, on the other hand, are usually the result of antecedent fungemia seeding the ocular tissue. Candida spp. are the most common cause of endogenous endophthalmitis, although initial infection with the dimorphic fungi may lead to infection and scarring of the chorioretina. Contact lens wear is associated with keratitis caused by yeasts, filamentous fungi, and Acanthamoebae spp. Most parasitic infections of the eye, however, arise following bloodborne carriage of the microorganism to the eye or adjacent structures.

Fungal and Parasitic Infections of the Eye

The unique structure of the human eye as well as exposure of the eye directly to the environment renders it vulnerable to a number of uncommon infectious diseases caused by fungi and parasites. Host defenses directed against these microorganisms, once anatomical barriers are breached, are often insufficient to prevent loss of vision. Therefore, the timely identification and treatment of the involved microorganisms are paramount. The anatomy of the eye and its surrounding structures is presented with an emphasis upon the association of the anatomy with specific infection of fungi and parasites. For example, filamentous fungal infections of the eye are usually due to penetrating trauma by objects contaminated by vegetable matter of the cornea or globe or, by extension, of infection from adjacent paranasal sinuses. Fungal endophthalmitis and chorioretinitis, on the other hand, are usually the result of antecedent fungemia seeding the ocular tissue. Candida spp. are the most common cause of endogenous endophthalmitis, although initial infection with the dimorphic fungi may lead to infection and scarring of the chorioretina. Contact lens wear is associated with keratitis caused by yeasts, filamentous fungi, and Acanthamoebae spp. Most parasitic infections of the eye, however, arise following bloodborne carriage of the microorganism to the eye or adjacent structures.

Listeria monocytogenes-induced endogenous endophthalmitis in an otherwise healthy.

An additional case of an otherwise healthy 73 year-old male, who was referred to our hospital because of acute iridocyclitis with secondary glaucoma, is reported. Within a few days the severity of the intraocular infection increased dramatically, resulting in the clinical picture of acute endophthalmitis. RESULTS In contrast to most published cases, early identification of the causative pathogen in the aqueous humor after anterior chamber puncture using polymerase chain reaction (PCR) and the initiation of a specific, systemic antibiotic medication, resulted in complete recovery of visual acuity. PCR is very useful for the identification of the pathogen in intraocular infections. (Eur J Ophthalmol 1999; 9: 53-7).

Listeria Monocytogenes-Induced Endogenous Endophthalmitis in an Otherwise Healthy Individual: Rapid PCR-Diagnosis as the Basis for Effective Treatment

Listeria monocytogenes is a rare cause of endogenous endophthalmitis. To date 15 cases have been published in the literature. All eyes showed similar clinical features and profound visual loss mainly due to delayed diagnosis. An additional case of an otherwise healthy 73 year-old male, who was referred to our hospital because of acute iridocyclitis with secondary glaucoma, is reported. Within a few days the severity of the intraocular infection increased dramatically, resulting in the clinical picture of acute endophthalmitis. In contrast to most published cases, early identification of the causative pathogen in the aqueous humor after anterior chamber puncture using polymerase chain reaction (PCR) and the initiation of a specific, systemic antibiotic medication, resulted in-complete recovery of visual acuity. PCR is very useful for the identification of the pathogen in intraocular infections.

Endogenous Endophthalmitis Caused by Streptococcus mitis

To report endogenous endophthalmitis caused by Streptococcus mitis. A 3-year-old girl was hospitalized for possible retinoblastoma after she suddenly developed a red and sensitive left eye. After administration of anesthesia, we examined the patient and obtained samples of aqueous, vitreous, and blood for culture. Blood and vitreous cultures grew S mitis. Intravenous and intravitreal injections of antibiotics were used to treat the infection. Streptococcus mitis should be considered a cause of endogenous endophthalmitis.