Hematogenous Endophthalmitis Research Articles

Orbital cellulitis and endogenous endophthalmitis secondary to Proteus mirabilis cholecystitis

We report the first case of orbital cellulitis and endogenous endophthalmitis secondary to Proteus mirabilis bacteremia that resulted from a calculus cholecystitis. Despite resolution of the gallbladder infection with antimicrobial therapy, the patient required evisceration of the affected eye. The pathogenesis of hematogenous endophthalmitis due to Gram-negative bacilli is discussed.

Candida endophthalmitis in non-neutropenic critically ill patients.

Six non-neutropenic critically ill patients who developed hematogenous endophthalmitis due to Candida spp. were studied prospectively. In all cases the yeast was isolated in blood cultures. The incidence of endophthalmitis in patients with candidemia was 13%, the predominant species being Candida albicans. Four patients were treated with fluconazole, but its efficacy could not be evaluated because three of the patients died. In patients at risk of candidemia, regular ophthalmoscopic examinations are recommended in order to enable early initiation of systemic antifungal therapy in those who develop endophthalmitis.

Hematogenous Endophthalmitis Due to Candida tropicalis: Report of Two Cases and Review

Candida tropicalis is a well-documented pathogen affecting humans. There is limited clinical and experimental evidence that C. tropicalis causes hematogenous endophthalmitis. We report two cases of C. tropicalis endophthalmitis and review 12 cases reported in the literature. Clinical presentation was similar to that described for Candida albicans endophthalmitis. Therapy with amphotericin B, with or without flucytosine, resulted in resolution of the lesions except in one patient, for whom enucleation of the eye was necessary to control the infection. None of the patients were leukopenic.

Experimental hematogenous endophthalmitis caused by Candida albicans.

For a rabbit model of hematogenous endophthalmitis caused by Candida, 80 New Zealand white rabbits were given intravenous injections of 10-5 Candida albicans. Two weeks after infection 88 percent of infected rabbits had ocular lesions with clinical appearance identical to that of human lesions. Cultures of the chorioretina and kidneys averaged 10-4.3 and 10-3.9 organisms per g of tissue, respectively, three days after infection and remained positive for 38 days. Ninety-five percent of rabbits with positive cultures of the chorioretina had positive cultures from other organs. The ocular lesions were focal chorioretinitis characterized by a combination of granulomatous and acute suppurative reactions. Hematogenous endophthalmitis caused by Candida in the rabbit is a useful model for study of the pathogenesis and treatment of the disease in humans.