Diagnosis Of Endogenous Endophthalmitis Research Articles

Endogenous Endophthalmitis in a Patient with Colorectal Cancer: A Case Report

A 58 year-old woman with a history of diabetes mellitus and rectal Adenocarcinoma presented with acute loss of vision and pain in the left eye with hypopyon with no systemic symptoms at presentation. Diagnosis of endogenous endophthalmitis was made. Treatement was medical by topical, intravitreal and systemic antibiotics, with poor visual outcome. This case reminds ophthalmologists that endogenous endophthalmitis might be associated with underlying malignancy.

Endogenous endophthalmitis associated with pyogenic liver abscess caused by Klebsiella pneumoniae: A case report

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess" is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

Endogenous Endophthalmitis Associated with Pyogenic Liver Abscess Caused by Klebsiella Pneumoniae: A Case Report

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

Incidence of Drug Use–Related Endogenous Endophthalmitis Hospitalizations in the United States, 2003 to 2016

Complications arising from the nationwide opioid epidemic led to an increase in health care use. Few studies have investigated whether this is reflected in hospital admissions for endogenous endophthalmitis. To report changing trends in epidemiology, risk factors, hospital course, and costs associated with drug use-related endogenous endophthalmitis hospitalizations in the United States from 2003 to 2016. Nationwide, retrospective cross-sectional study using the National Inpatient Sample. A total of 56 839 patients admitted with a diagnosis of endogenous endophthalmitis were included. Data were analyzed between 2003 and 2016. Inpatient admission for endogenous endophthalmitis during the years 2003 to 2016. The Nationwide Inpatient Sample was queried to identify all inpatient admissions with a diagnosis of endogenous endophthalmitis in the United States between the years 2003 and 2016. Analyses were performed to identify national and regional trends in incidence and prevalence of associated infectious and noninfectious comorbidities in patients with or without a history of drug dependence or use. Median and cumulative inflation-adjusted costs for admissions were calculated. Of all patients, 55.6% were White, 13.6% were Black, and 10.6% were Hispanic. There were an estimated 56 839 endogenous endophthalmitis-related hospitalizations; 13.7% of these patients (n = 7783) had a history of drug dependence or use. The drug-using population was significantly younger (49.6 vs 57.5 years; difference, 7.9; 95% CI, 6.93-8.88; P < .001) and more likely to be male (61.8% [n = 35 127] vs 49.0% [n = 21 712]; difference, 12.8%; 95% CI, 11.6%-14.0%; P < .001). The incidence of endogenous endophthalmitis associated with drug dependence or use increased from 0.08 per 100 000 in 2003 to 0.32 per 100 000 population in 2016 across all 4 US geographic regions. A 4-fold increase in drug use-related endogenous endophthalmitis hospitalizations was observed in the United States from 2003 to 2016, resulting in substantial health care use burden. These findings support the hypothesis that clinicians should maintain a high index of suspicion for endophthalmitis when evaluating patients with intraocular inflammation in the setting of drug dependence or use.

Endogenous endophthalmitis as a severe complication following a Streptococcus pyogenes infection

The diagnosis of endogenous endophthalmitis is challenging. We report a pediatric case of endogenous endophthalmitis due to Streptococcus pyogenes angina. A previously healthy 33-month-old child presented to the emergency department with a history of fever and fatigue related to bacterial angina. On physical examination, an opalescent cornea was noticed and the diagnosis of endogenous endophthalmitis was confirmed by the pediatric ophthalmologist. Streptococcus pyogenes was found in blood culture and in the anterior chamber fluid. There was an adverse outcome with posterior vitrectomy and eye atrophy. Since endogenous endophthalmitis can lead to a poor visual outcome, urgent therapeutic management is necessary.

Endogenous Endophthalmitis: Has the Opioid Crisis Impacted the Rates and Severity of Intravenous Drug-Related Cases?

Purpose:Endogenous endophthalmitis is an intraocular infection associated with systemic illness and/or intravenous drug use (IVDU). Rising national rates of IVDU may have impacted rates and outcomes of endogenous endophthalmitis. The purpose of the current study is to compare rates and treatment outcomes in endogenous endophthalmitis with and without a history of IVDU.Methods:This is a single-center retrospective consecutive case series of 21 eyes of 17 patients with a diagnosis of endogenous endophthalmitis from May 2014 to December 2016. Clinical characteristics and treatment outcomes were compared between IVDU and non-IVDU groups.Results:A history of IVDU was present in 3 of 17 patients (18%), whereas the other 82% had systemic comorbidities. There was no statistically significant difference in presenting visual acuity (VA) between the IVDU and non-IVDU groups (20/630 vs 20/500, P = .75). Pars plana vitrectomy was performed at some point in the clinical course of 80% of eyes (4/5) in the IVDU group and 56% of eyes (9/16) in the non-IVDU group. Staphylococcus or Candida were the predominant causative organisms isolated in the IVDU and non-IVDU groups. Statistical analyses revealed trends towards worse last VA in the non-IVDU group compared with the IVDU group (20/1000 vs 20/110, P = .10).Conclusions:Compared with historical data from the same institution, there has not been an increase in the rates of IVDU-associated endogenous endophthalmitis at this tertiary referral center. VA outcomes are often poor in both groups, but there may be a better prognosis for IVDU-associated endogenous endophthalmitis.

Endogenous endophthalmitis following prolong use of methotrexate

A 46 yr old male presented to us with a 2 day history of pain, redness and discharge in left eye. The patient was on oral Methotrexate (12.5 mg) weekly with folic acid supplement for the last 1 year for recurrent Uveitis (LE). There was a history of three previous episodes of acute anterior uveitis in left eye 2 years back for which he was prescribed oral steroids. The uveitis attack use to flare up on tapering the steroids. In the hope to reduce the recurrences and to prevent long-term complications, the patient was shifted to oral methotrexate (12.5 mg) weekly with folic acid supplementation. On the basis of clinical examination and B- scan a presumptive diagnosis of endogenous endophthalmitis was made. Vitreous tap revealed a straw colored sample and the culture subsequently grew methicillin sensitive Staphylococcus epidermidis. Intravitreal injection of (Piperacillin+Tazobactum) 225 microgram in 0.1 ml was administered. In addition, intravenous (piperacillin+tazobactum) 4.5 gram BD was given for 3 days. Post intra vitreal injection the symtoms and signs resolved remarkably. Methotrexate has not been previously implicated with endogenous endophthalmitis. Besides, Endogenous endophthalmitis is an ongoing diagnostic and therapeutic dilemma for ophthalmologists as it is relatively rare and often presents like uveitis. It requires a high index of suspicion for prompt diagnosis and treatment. The treatment of EE is still controversial due to a lack of clinical trials. Future large group studies need to be done for validation of the above therapeutic regime.

Endophthalmitis as a first manifestation of right-sided endocarditis in a patient with patent foramen ovale.

Endogenous endophthalmitis is a rare complication of endocarditis, rendering poor visual prognosis. We report a case of a 66-year-old female with renal failure who presented with fever, ocular pain, and purulent eye discharge. After a diagnosis of endogenous endophthalmitis, she was treated with antibiotics and enucleation of the eye. Due to persistent fever and positive blood cultures, a transesophageal echocardiography was undertaken, disclosing a large mural vegetation in the right atrium, catheter-associated vegetations, and a patent foramen ovale. Endocarditis is an uncommon source of endogenous endophthalmitis, and has rarely been associated to right-sided endocarditis and paradoxical septic embolization.

Endophthalmitis: A Rare but Devastating Metastatic Bacterial Complication of Hemodialysis Catheter-Related Sepsis

There are many infectious complications related to vascular access in patients undergoing maintenance hemodialysis. We report two cases of endophthalmitis as a metastatic infection associated with a tunneled catheter and a temporary dual lumen catheter. Both patients were diabetic. A 61-year-old female on maintenance hemodialysis by a jugular tunnelized catheter during the past year was receiving parenteral antibiotics for catheter salvage due to fever episodes in the last 3 months. She was admitted to the hospital presenting pain, proptosis, conjunctival hyperemia, corneal infiltrate, and visual acuity of no light perception (NLP). A 51-year-old male recently undergoing hemodialysis by a temporary dual lumen catheter presented fever. His catheter was removed, but he was admitted to the hospital presenting fever, decreased vision, edema, and pain in his left eye. On examination, eyelid edema, conjunctival hyperemia, purulent secretion, hypopyon in the pupils, and visual acuity of NLP were verified. A diagnosis of endogenous endophthalmitis was made in both patients on clinical grounds and computed tomography. Evisceration of the left eye was the first option of treatment for both patients due to poor vision. Cultures of the eviscerated ocular globes showed Staphylococcus hemolyticus and Staphylococcus aureus, respectively. After evisceration, both patients received treatment, had a good outcome, and were discharged to continue their hemodialysis program. Metastatic bacterial endophthalmitis is a rare complication of dialysis catheter-related bacteremia. When suspected, urgent ophthalmologic evaluation and treatment are needed to reduce the risk of losing vision in the affected eye.

Endophtalmie endogène àKlebsiella pneumoniae sur abcès rénal : à propos d’un cas

We report the case of an 86-year-old man with unilateral panuveitis concurrent with an infectious retinal focus. The diagnosis of endogenous endophthalmitis with subretinal abscess was suggested. The biology workup and CT scan showed a renal abscess. This was caused by Klebsiella pneumoniae, which was confirmed by analysis of abscess aspiration and vitrectomy samples. This paper underscores the importance of etiological assessment in infectious panuveitis and the consequences on visual outcome.

Endogene Endophthalmitis

In the rare condition of endogenous (or metastatic) endophthalmitis, septicemia leads to intraocular colonization by bacteria, fungi or parasites. Immunologically compromised or multimorbid patients are commonly affected by this ophthalmological emergency. Although appropriate anti-infective drugs and modern surgical treatment are available, this disease still has a poor prognosis in terms of organ and function preservation. Between March 2003 and September 2005 nine patients (5 male, 4 female, average age: 60.6 years) with a diagnosis of endogenous endophthalmitis were treated in the Ophthalmology Department of Rostock University Hospital. The infection was in a very advanced stage in eight cases. Six patients offered no fundus view, and in three cases the intraocular view was heavily blurred. Eight patients had an initial visual acuity of <or=20/200, six had visual acuity<or='counting fingers' at the time of first presentation and three patients had no light perception. Primary enucleation was required in two cases. Seven patients were treated with a pars plana vitrectomy, membrane peeling and endotamponade. Six patients developed complications, necessitating a repeat intervention. Microbiological organism identification from a vitreal tap was successful in three cases. A fourth agent isolated (Pyrenophora tritici) is of no pathogenic importance in humans. In the vitrectomy group stabilization of visual acuity was achieved in three cases, and distinctly improved final visual acuity compared to baseline was achieved in four cases. Identification of endogenous endophthalmitis at an early stage with immediate initiation of therapy has significant implications for the further course of the disease. If--as in the present study--advanced cases are present with complicating internal or surgical disease and no possibility of short-term follow-up, pars plana vitrectomy should be given priority over single intravitreal injections. Major comparative investigations are desirable regarding the most appropriate method of endotamponade. Highlighting this clinical pattern more widely in non-ophthalmological specialties (e.g. intensive care, surgery) might decrease the rate of adverse outcomes associated with this disease.

Electrosurgery with a fiberoptic bronchoscope and a snare for endotracheal/endobronchial tumors

J Thorac Cardiovasc Surg 1998;116:177-9