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Acute Endophthalmitis

Sympathetic Ophthalmia


Presentation

  • No predisposing risk factors for endophthalmitis or postoperative hypotony were present. Cultures were positive for coagulase negative staphylococcus.[ncbi.nlm.nih.gov]
Noncompliance
  • Risk factors include Steven-Johnson syndrome, ocular cicatricial pemphigoid, noncompliance with antibiotics, nonuse of vancomycin, poor contact lens hygiene, corneal melting, and infectious keratitis.[entokey.com]
Hypotension
  • Keep the infusion line primed and within the operating field to avoid complications secondary to ocular hypotension while obtaining the non-dilute sample.[entokey.com]
  • The limitations of intravenous amphotericin B include required hospitalization, severe ocular inflammation, and numerous systemic adverse effects such as nephrotoxicity, fever, rigors, and hypotension. 60 Triazole Agents Fluconazole is an older-generation[touchophthalmology.com]
Flushing
  • […] of intravitreal suppuration may preclude needle aspiration of the VH; in such cases, pure or diluted VH can be collected via a pars plana vitrectomy in the following manner: After connecting a 3-cc syringe to the aspiration line of the vitreotome and flushing[retinatoday.com]
Periorbital Edema
  • Signs of endophthalmitis include eyelid or periorbital edema, ciliary injection, anterior chamber reaction, corneal edema, and retinal hemorrhages, vitreous inflammation [7,8].[casereports.in]
Rubeosis Iridis
  • Risk factors for reduced final VA included symptoms within 2 days of surgery, LP on presentation, relative afferent pupillary defect, non-intact posterior capsule, IOP less than five or more than 25 mmHg, rubeosis iridis, corneal infiltrate, melting and[entokey.com]
Foreign Body Sensation
  • The most significant findings at the diagnosis were decreased visual acuity (96%), pain (84%), hyperemia (73%), eyelid edema (42%), headache (4%), foreign body sensation (4%) and fever (2%).[scielo.br]
Agitation
  • This technique has several advantages over conventional culture media, including higher sensitivity (owing to permanent agitation of cultures) and a lower risk of contamination during sample handling.[retinatoday.com]

Workup

  • […] approx 7% Injuries including IOFB have higher rates Risk factors Other risk factors: dirty wound, lens capsule rupture, age 50, delayed presentation of more than 24 hours after injury Bacillus and Staphylococcus are common in penetrating trauma with IOFB Workup[eyewiki.aao.org]
Dyslipidemia
  • He was diagnosed with type II diabetes mellitus, dyslipidemia and prescribed subcutaneous novorapid 3x8 IU.[casereports.in]
Clostridium Perfringens
  • .; many polymicrobial B. cereus, S. aureus, coliforms, streptococci, and Clostridium perfringens. Remove IOFB; Intravitreal amikacin 400 microgm (or gentamicin 200 microgm) plus vancomycin 1mg and/or clindamycin 1mg.[infectiousdiseaseadvisor.com]

Treatment

  • There was no additional effect for treatment by primary vitrectomy or intravitreal prednisolone. CONCLUSIONS: Treatment outcome after endophthalmitis is highly dependent on the causative organism.[ncbi.nlm.nih.gov]

Prognosis

  • There is often a guarded visual prognosis. Figure 1. Inferior hypopyon (pus in the anterior chamber). The cornea is hazy from inflammation.[racgp.org.au]
  • Gram-negative infections with Pseudomonas also has poor prognosis. Coagulase-negative staphylococci has a very good prognosis. Interventions that delayed more than 24 hours after onset will have worse visual outcomes.[infectiousdiseaseadvisor.com]
  • Vision prognosis is often poor, even with early and appropriate treatment. Patients whose vision at presentation is count-fingers or worse should be considered for vitrectomy and use of intraocular corticosteroids.[merckmanuals.com]
  • Clinical course and prognosis: The prognosis for acute microbial endophthalmitis depends on the virulence of the pathogen and how quickly effective antimicrobial therapy can be initiated.[alpfmedical.info]
  • Posttraumatic cases are commonly infected with streptococcal and gram-negative organisms that are associated with poor visual prognosis.[pubs.sciepub.com]

Etiology

  • BACTERIOLOGIC IDENTIFICATION TECHNIQUES Culture Methods The isolation of microorganisms in culture is the reference method for determining the etiology of endophthalmitis.[retinatoday.com]
  • Any future trials should examine whether adjunctive steroids may be useful in certain clinical settings such as type of causative organism or etiology.[ncbi.nlm.nih.gov]
  • Etiology of Endophthalmitis, Usual Pathogens and Suggested Initial Therapy Table I.[infectiousdiseaseadvisor.com]
  • Infectious endophthalmitis can have either an exogenous (following ocular surgery/ penetrating trauma ) or endogenous (hematogenous spread) etiology.[amboss.com]

Epidemiology

  • However, before culture results are available, empiric treatments based on the epidemiological findings in the community may be used.[nature.com]
  • Outcomes of more than 480 000 cataract surgeries, epidemiologic features, and risk factors. Ophthalmology. 2016;123:295–301. CrossRef PubMed 6. Taban M, Behrens A, Newcomb RL, et al.[springermedizin.at]
  • Discussion of Epidemiology and Treatment: The incidence of post cataract surgery endophthalmitis has varied over the past century.[eyerounds.org]
  • Epidemiology Endogenous endophthalmitis can occur at any age and has no sexual predilection.[aafp.org]
  • Epidemiologic surveillance of postoperative endophthalmitis in a specialized ophthalmologic center in São Paulo, Brazil. Am J Infect Control. 2012;40(1):e1–3. 18. World Medical Association.[sboportal.org.br]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Normally, the blood-ocular barrier prevents invasion from infective organisms but if this is breached (directly through trauma or indirectly due to a change in its permeability secondary to inflammation), infection can occur.[patient.info]
  • Pathophysiology Under normal circumstances, the blood-ocular barrier provides a natural resistance against invading organisms.[emedicine.medscape.com]

Prevention

  • Multiple preventive measures are used to try to prevent infection after surgery.[cochranelibrary.com]
  • Preoperative prophylactic antibiotic usage may be considered as a preventive measure in sutureless vitrectomy.[ncbi.nlm.nih.gov]
  • ABSTRACT Acute endophthalmitis is a serious complication of cataract surgery that, given its infectious etiology, can be prevented using antiseptics and antibiotics.[200.98.68.239]

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