Hematogeneous osteitis due to Yersinia enterocolitica.
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Biomedical subjects
Publications and source records attributed to G Haroche.
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Fifteen patients awaiting cataract extraction were given a 2 g intravenous bolus injection of aztreonam. The mean aztreonam concentrations in the aqueous humour. 1, 2 and 4 h after the injection were 1.22, 1.46 and 2.22 mg/l, respectively.
In 20 patients undergoing cataract extraction, we measured pefloxacin concentrations in the eye. After a 1 h infusion of pefloxacin 400 mg iv, the mean pefloxacin concentrations 2, 6, 12 and 24 h post-infusion were 0.75, 1.45, 1.04 and 0.86 mg/l, respectively. The simultaneous mean pefloxacin concentrations in the lens were 0.09, 0.20, 0.26 and 0.43 mg/l, respectively. The adequate penetration of pefloxacin into uninfected aqueous humour and lens suggests that this antibiotic may be effective in the treatment of certain bacterial endophthalmic infections.
18 cases of bacterial endophthalmitis are reported. From bacteriological, epidemiological, pharmacokinetic data, we can propose a management of infectious endophthalmitis based on the two following rules: systematic intraocular fluid aspiration, on emergency, for stained smears (as real bacteriological extemporaneous investigations) and cultures; initial wide spectrum antibiotherapy with a quick adaptation to gram stain and culture identification. The antibiotics are selected according to their intraocular penetration, safety and spectrum. The intraocular bactericidal concentration requires the association of systemic, peri-ocular, and intraocular antibiotherapy, before the settlement of irreversible retinal lesions. By vitrectomy, the infected vitreous may be cleared, and intraocular drugs diffuse more easily.
Three cases of Candida albicans endophthalmia in drug addicts are reported. Three important signs suggestive of a fungal etiology for choroiditis are discussed: location of the granuloma at the end of a macular arteriole, early leak of fluorescein to the vitreous body, and solitary papillitis.
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