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At least 19 recordsLinked to original sources
PubMed1976

Phacoanaphylactic endophthalmitis: echographic diagnosis of phacoanaphylactic endophthalmitis.

A sixty-year-old black diabetic female developed a severe postoperative endophthalmitis eight days after unplanned extracapsular cataract surgery. Gram stain of a diagnostic vitreous aspirate showed no organisms, and culture of the aspirate was negative for bacteria and fungi. A- and B-scan ultrasonography showed the presence of intra-vitreal lens fragments; the diagnosis of phacoanaphylactic endophthalmitis was made and intensive steroid therapy was instituted early in the course of the disease. Resorption of the lens fragments in association with gradual diminution of the inflammatory process was documented by serial echograms of the eye. The vitreous ultimately cleared and the patient regained useful vision. Ultrasonography is recommended as an essential part of the diagnostic evaluation of any patient with postoperative endophthalmitis especially with a history of extracapsular surgery.

Anaphylaxis↗
PubMed1979

Vitrectomy in experimental endophthalmitis: Part II--Bacterial endophthalmitis.

Three methods of treatment for Staphylococcus aureus endophthalmitis were compared: subconjunctival injection with intramuscular gentamicin, intravitreal injection with intramuscular gentamicin, and vitrectomy using infusion solution containing gentamicin along with intramuscular gentamicin. Subconjunctival injection with intramuscular gentamicin was not successful in treating infection. Intravitreal injection with intramuscular gentamicin and vitrectomy with intramuscular gentamicin were equally effective in eradicating infection; however, the combination of vitrectomy and intramuscular gentamicin provided clearer vitreous with greater fundus detail.

Animals↗
PubMed1992

[Bacterial endophthalmitis. Ophthalmological results of a national multicenter prospective survey].

Under the aegis of the GEEP (Groupement d'Etudes Epidémiologiques et Prophylactiques) a prospective multicentre study concerning bacterial endophthalmitis was carried out over a period of one year long with the contribution of 64 metropolitan ophthalmologic hospital departments. During this survey 143 cases of post surgical endophthalmitis were recorded: 111 of them were secondary to elective surgery, 32 developed after a perforating eye injury. Twenty-four cases of endophthalmitis developed in the absence of surgery were therefore called "medical" endophthalmitis. The frequency of endophthalmitis after elective surgery was 0.32%, and 2.8% after penetrating eye injury. Intraocular samples were obtained in 61.5% of the cases of post surgical endophthalmitis. 53 bacteria were isolated from 50 cases of endophthalmitis. The bacterial nature of the endophthalmitis was proved in 35% of these cases of post surgical endophthalmitis. Bacteria isolated from these cases of post surgical endophthalmitis were gram positive in 86.7%, and gram negative in 13.3% of cases. 20 bacteria were isolated from pseudophakic eyes: 10 of them were Staphylococcus epidermidis. The visual prognosis of endophthalmitis depends on the strain: visual acuity was more than 1/10 in 68% of cases of Staphylococcus endophthalmitis infection, but in only in 7% of cases of Streptococcus endophthalmitis infection. Intraocular injections of antibiotics both in the anterior chamber and in the vitreous, and vitrectomy increased the quality of the visual result. Three months after post surgical endophthalmitis, 35% of those eyes who received systemic and periocular antibiotic therapy, combined with intraocular antibiotics, with or without vitrectomy, recovered a visual acuity of 4/10 or more, instead of only 18% in the group without any intraocular therapy.

Adolescent↗
PubMed1978

Diagnostic limulus lysate assay for endophthalmitis and keratitis.

The limulus lysate assay is an inexpensive, reliable, and rapid means of detecting and presence of Gram-negative endotoxin. In all ten cases of experimentally induced Proteus endophthalmitis in rabbits, the assay was positive, and the assay was appropriately negative in all ten cases of Staphylococcal endophthalmitis, ten cases of Candida endophthalmitis, and ten cases of sterile endophthalmitis in rabbits. In a clinical assessment of keratitis, the assay of corneal scrapings was positive in 11 of 13 Gram-negative corneal ulcers. In a similar study of clinical endophthalmitis, both Gram-negative cases had a negative limulus assay, but two cases are insufficient to be conclusive. The assay may prove to be a useful adjunct both to standard diagnostic evaluations and in the rapid direction of appropriate therapy for these conditions.

Animals↗
PubMed1992

Pseudophakic endophthalmitis.

We performed a retrospective study on 45 patients admitted to the Rotterdam Eye Hospital and the Ophthalmic Department of the Academic Medical Center in Amsterdam with pseudophakic endophthalmitis. Vitreous loss during cataract extraction was associated with a significantly increased risk of postoperative endophthalmitis when compared with uncomplicated cataract extraction (p < 0.0001). The incidence of pseudophakic endophthalmitis in diabetic patients was not significantly higher as compared to non-diabetic patients. Vitrectomy in the treatment of postoperative endophthalmitis did not improve the final visual acuity, probably because of selection bias. Methicillin and cephazolin, used intravitreally against gram-positive organisms, failed to provide a good coverage for endophthalmitis due to Staphylococcus epidermidis.

Aged↗
PubMed1976

Experimental lens-induced granulomatous endophthalmitis.

Experimental lens-induced granulomatous endophthalmitis is an experimental autoimmune disease that is histopathologically identical to the human disease known as phacoanaphylactic endophthalmitis or lens-induced uveitis. The capacity to develop experimental disease after lens injury can be passively transferred to virgin animals with hyperimmune serum. Fluorescein-labeled anti-IgG and anti-C'3 antisera bind to the lenses of appropriately sensitized animals after lens injury but not to the injured lenses of unsensitized control animals. Cobra Venom factor which inhibits C'3 prevents the development of lens-induced granulomatous uveitis in appropriately sensitized animals. Hypersensitized animals develop a massive Arthus-like reaction. On the basis of these observations we feel that experimental lens-induced granulomatous endophthalmitis is an immune complex disease. Because the experimental disease is histopathologically identical to human lens-induced uveitis or phacoanaphylactic endophthalmitis we believe an immune complex mechanism of immunopathogenesis is important in phacoanaphylactic endophthalmitis.

Animals↗
PubMed1979

Experimental hematogenous Candida endophthalmitis: diagnostic approaches.

Anterior chamber aspiration and vitreous aspiration were evaluated as diagnostic procedures for establishing a specific microbiological diagnosis in the rabbit model of hematogenous Candida endophthalmitis. Vitreous aspiration was the most successful procedure, confirming the diagnosis of hematogenous Candida endophthalmitis in 62% of eyes with documented intraocular infection. When animals with only the most severe clinical endophthalmitis were considered, vitreous aspiration confirmed the diagnosis in 89% of eyes evaluated. Vitreous aspiration correlated well with the extent of clinical endophthalmitis, as well as with postmortem, whole-vitreous cultures. Gram staining of the aspirate was additive to culture results in confirming the diagnosis. Anterior chamber aspiration was positive in only 1 of 58 eyes evaluated (1.7%). Additionally, muscle biospy was evaluated in this study as a tool for establishing a microbiological diagnosis in the rabbit model of disseminated candidiasis. Only 2 of 131 biospy specimens contained detectable Candida. Although vitreous aspiration may be associated with ocular complications, in certain clinical settings this procedure may be valuable in establishing the definitive microbiological diagnosis of hematogenous Candida endophthalmitis.

Animals↗
PubMed1992

Endophthalmitis: incidence, therapy and visual outcome in the period 1983-1992 in the Rotterdam Eye Hospital.

From 1983 to 1992, 134 patients were treated for clinically suspected endophthalmitis. 61% of this endophthalmitis population consisted of cases that were referred to our clinic. In this nine year period antibiotic treatment was carried out according to three consecutively used guidelines. These three treatment schemes differed in antibiotic spectrum and mode of antibiotic delivery. In 68 patients we performed vitrectomy on account of clinical deterioration under antibiotic treatment. We did not find significant differences in visual outcome between the three treatment groups. The incidence of endophthalmitis following cataract or vitreous surgery did not change throughout the study period. There was however a dramatic decrease in incidence of post-traumatic endophthalmitis following the introduction of a prophylactic antibiotic treatment scheme consisting of fortified gentamicin and cefazolin eyedrops, and intravenously and subconjunctivally administered gentamicin, cefazolin, and clindamycin. In 55 of 68 cases in which vitrectomy was performed in conjunction with intravitreal antibiotics, a vitreous or anterior chamber specimen was cultured. 36 patients had a positive culture result. In the group with positive culture result 42% had better visual acuity in the post-treatment period than before treatment. In the group with a sterile culture result 79% had better vision after treatment.

Anti-Bacterial Agents↗
PubMed1992

[Chronic Corynebacterium endophthalmitis. Apropos of 3 cases].

Only a few isolated cases of endophthalmitis have Corynebacterium been implicated as etiology. This diphtheroid, which has been considered for a long time as a nonpathogenic contaminant from the conjunctival flora, may produce systemic diseases usually in immuno-deficient patients. Keratitis and endophthalmitis cases have been reported in the literature. We report three cases of chronic endophthalmitis after extracapsular extraction with intraocular chamber posterior lens which are characterized by many subacute iridocyclitis and vitritis attacks treated by topical steroids. These endophthalmitis are characterized by decrease of visual acuity, hypopion, white plaque on posterior capsule and vitritis. In the first case, Corynebacterium has been isolated from the culture of vitreous and in the second and third cases from the culture of aqueous humor. These bacteria are often very slow growing, 8 to 14 days in the 3 cases. Colonies may not become visible on culture plates before one week or more. Corynebacterium grow well on ordinary media (blood and chocolate agar). The major difficulty is not to discard organism frequently considered contaminants. The treatment associated systemic antibiotherapy with steroids or not, central capsulotomy and vitrectomy with intraocular injection of antibiotic with or without steroids. Antibiotics sensitivities among diphteroids vary greatly. Quinolones, penicillins, vancomycin, cyclines and aminosides are often a good choice. However, individual sensitivities determined by the antibiogram must be used for an appropriate treatment.

Aged↗
PubMed1978

Endophthalmitis following staphylococcal sepsis in renal failure patients.

Endophthalmitis occurred three months following completion of therapy for documented staphylococcal septicemia in two patients on long-term hemodialysis. The indolent course of the endophthalmitis, and its excellent response to systemic and subconjunctival antibiotics and subconjunctival and topical corticosteroid therapy, suggest the possibility that the acute fulminating clinical course of metastatic bacterial endophthalmitis may be modified in this population of patients. The reason for this modified clinical picture is probably the immune incompetence associated with uremia, which favors both the development of metastatic endophthalmitis as well as altering its clinical presentation. While funduscopic examination is suggested in all dialysis patients with eye complaints, this procedure becomes mandatory following episodes of sepsis.

Adult↗
PubMed1976

Flavobacterium endophthalmitis following keratoplasty. Use of a tissue culture medium-stored cornea.

This case of Falvobacterium meningosepticum endophthalmitis in the immediate postoperative period following a penetrating keratoplasty represents the first known isolation of F meningosepticum from the eye and, also, our first encounter with bacterial endophthalmitis following keratoplasty. This case occurred soon after conversion from whole eye moist chamber storage to tissue culture storage (McCarey-Kaufman medium). This storage technique may predispose to development of postoperative endophthalmitis. We offer suggestions to minimize the possibility of such infection.

Aged↗
PubMed1978

Endophthalmitis after trabeculectomy.

Two cases of late endophthalmitis after trabeculectomy surgery are described. Despite intensive antibiotic therapy, the visual end result in both cases was poor. The incidence of endophthalmitis after trabeculectomy, according to this report is similar to that after Scheie's procedure, but less than that after trephination. A possible cause of endophthalmitis is the anterior dissection of the superficial scleral flap into the cornea.

Aged↗
PubMed1978

The limulus lysate test. A rapid test for diagnosis of Pseudomonas keratitis or endophthalmitis.

The limulus amebocyte lysate test has been shown to be a highly sensitive indicator of endotoxin. Our studies showed that as little as 5 ng of endotoxin could be detected in aqueous or vitreous humor in vitro, although 10 microgram endotoxin injected into the aqueous could not be detected. Subsequent studies showed that by diluting the aqueous equally with saline solution, this inhibitory effect could be overcome. Detection of endotoxin elaborated from Pseudomonas aeruginosa was made as early as 24 hours after induced Pseudomonas keratitis or endophthalmitis, whereas staphylococcal-induced keratitis or endophthalmitis gave negative results. Positive cultures using trypticase soy broth or agar slants were observed on all infected animals. Thus, this technique should have ready application for rapid detection of Pseudomonas keratitis or endophthalmitis.

Animals↗
PubMed1979

Corynebacterium endophthalmitis. Laboratory studies and report of a case treated by vitrectomy.

A Corynebacterium sp was isolated from the vitreous humor under aseptic conditions on two separate occasions from a patient with endophthalmitis resulting from a penetrating injury by a metallic foreign body. The metallic foreign body was removed during a pars plana lensectomy and anterior vitrectomy procedure; intravitreously injected methicillin sodium, gentamicin sulfate, and dexamethasone sodium phosphate gave a functional visual result. Intravitreous inoculation of rabbits with the Corynebacterium isolate produced an endophthalmitis similar to that produced in the patient, and subsequent cultures from the vitreous of the inoculated rabbits grew the same Corynebacterium sp. To our knowledge, this is the first reported case of endophthalmitis in which a Corynebacterium sp was documented by intraocular culture.

Adult↗
PubMed1979

Endophthalmitis associated with Haemophilus influenzae type b bacteremia and meningitis.

The unusual occurrence of endophthalmitis associated with Haemophilus influenzae type b bacteremia and meningitis was confirmed in three young children during a five-year period. In contrast to bacterial endophthalmitis attributed to other microorganisms, these three infections resolved completely within a few days with conventional antimicrobial therapy. Endophthalmitis is but one of the apparently increasing number of unsuual complications that may be observed as a result of H influenzae type b bacteremia.

Administration, Topical↗
PubMed1979

Meningococcal sepsis with endophthalmitis.

Endophthalmitis is a rare complication of meningococcemia. A child had endophthalmitis as the initially occurring complaint. Although both eyes appeared inflamed, the pupil in the right eye was fixed and dilated, the fundus could not be seen, and a hypopyon was seen in the right anterior chamber. There was gradual improvement when the child received antibiotic therapy. Since the introduction of antimicrobial drugs, endophthalmitis has rarely been observed as a complication of meningococcal disease. However, this report is evidence that meningococcemia may occur with unusual sites of local infection.

Child, Preschool↗
PubMed1976

Further observations on the diagnosis cause, and treatment of endophthalmitis.

In our study of 54 suspected cases of endophthalmitis, vitreous aspiration was more sensitive in making a culture-proven diagnosis than anterior chamber paracentesis; Staphylococcus epidermidis was a more common cause of endophthalmitis than previously appreciated; and intraocular antibiotics in the recommended dosage are reasonably safe clinically and add a new dimension to the treatment of endophthalmitis.

Anterior Chamber↗