scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

Abstract Backgrounds Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess. Methods Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery. Results Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction. Conclusion Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

Abstract Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgeryResults: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

Abstract Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery.Results: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

Abstract Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery.Results: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction.Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Control Disease ◽  
Serious Disease ◽  
Susceptibility Tests

Abstract BackgroundEndogenous endophthalmitis is a serious disease caused by intraocular infection, that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess.MethodsBetween April 2014 and April 2019, the clinical data of patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we also evaluated the degree of visual acuity correction in patients after surgery to determine the efficacy of vitrectomy.ResultsFifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) was only underwent intravitreal injection. Three patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5.26%) had visual acuity restored to 20/200, 6 eyes (31.58%) had visual acuity restored to counting fingers (CF), 2 eyes (10.53%) had visual acuity restored to hand motion (HM), 4 eyes (21.58%) showed only light perception (LP), and the remaining 6 eyes showed no light perception (NLP),3 patients showed carbapenems resistance.ConclusionEndogenous endophthalmitis caused by liver abscess is occult, and prognosis is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest.

Intravitreal Dexamethasone in the Management of Acute Endophthalmitis: A Comparative Retrospective Study

2016 ◽  
Vol 27 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Elad Moisseiev ◽  
Sam Abbassi ◽  
Susanna S. Park
Keyword(s):  
Intravitreal Injection ◽  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Complication Rates ◽  
Light Perception ◽  
Motion Vision ◽  
Hand Motion ◽  
Bacterial Endophthalmitis ◽  
Intravitreal Dexamethasone

Purpose To compare the clinical outcome of eyes with acute bacterial endophthalmitis treated with intravitreal injection of antibiotics with or without intravitreal dexamethasone. Methods This was a retrospective chart review of 63 eyes diagnosed with acute bacterial endophthalmitis and treated with vitreous tap and intravitreal injection of antibiotics, 19 eyes (30.2%) with and 44 eyes (69.8%) without concurrent intravitreal dexamethasone. Results Visual acuity had significantly improved by 1 week and was maintained long-term (p<0.001). There were no differences in visual outcome or rates of ocular complications between the groups. None of the eyes treated with dexamethasone required repeated intravitreal antibiotic injection while 6 (13.6 %) of the other eyes required repeated intravitreal antibiotic injection (p = 0.09). A subset analysis of 21 eyes that presented with light perception/no light perception vision where vitrectomy was not possible demonstrated that intravitreal antibiotic injection improved vision and achieved similar visual gain as in eyes that presented with hand motion vision or better, with no higher complication rates. Conclusions No adverse effect of intravitreal dexamethasone in the acute management of infectious endophthalmitis was noted. A trend toward less need for repeat intravitreal antibiotic therapy was noted in eyes with acute bacterial endophthalmitis treated with concurrent intravitreal dexamethasone at presentation.

scholarly journals Treatment Strategies in Acute Post-operative Endophthalmitis after Cataract Surgery at a Tertiary Eye Hospital in Nepal: A 5-year Retrospective Review

2021 ◽  
Vol 13 (1) ◽  
pp. 82-90
Author(s):  
Barsha Suwal ◽  
Deepak Khadka ◽  
Arjun Shrestha ◽  
Rajan Shrestha
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Intravitreal Injection ◽  
Hand Movement ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Oral Steroid ◽  
Oral Antibiotic ◽  
Pars Plana

Introduction: Despite best possible preventive measures, acute postoperative endophthalmitis (POE) is still the most devastating, sight-threatening complication after intraocular surgery and the most feared complication by treating surgeons. Materials and methods:  It is a retrospective study of 22 eyes diagnosed as acute POE following cataract surgery in the last 5 years (2015-2019), aimed to evaluate the treatment strategies used in its management. Main outcome measures evaluated were rates of repeat intravitreal injection, adjunctive therapeutic regimens, pars plana vitrectomy (PPV) and visual outcome. Results: Twenty one eyes (95.45%) received repeated intravitreal injection. Adjuvant intravitreal steroid was used in 12 eyes (54.54%), oral steroid in 16 eyes (72.72%) and oral antibiotic in 8 eyes (36.36%). PPV was done in 8 eyes (34.78%) and all 8 eyes that underwent PPV had a vision of Hand Movement (HM) close to face. 7 eyes (87.5%) had early PPV within 1 week of diagnosis. The median best corrected visual acuity (BCVA) improved from 1.00 logMar to 0.8 logMar following treatment at 3 months follow up (p= 0.117).  Conclusion: Repeat intravitreal injections were commonly employed. Early PPV was performed more commonly regardless of the visual acuity at the time of diagnosis of acute POE. 

scholarly journals A 14-Year Retrospective Analysis of Endogenous Endophthalmitis in a Tertiary Referral Center of Southern Thailand

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Patama Bhurayanontachai ◽  
Phingphan Klongthanakit
Keyword(s):  
Visual Acuity ◽  
Visual Outcome ◽  
Patient Characteristics ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Gram Positive ◽  
Gram Negative ◽  
Visual Outcomes ◽  
Presenting Symptoms ◽  
Final Visual Outcome

Purpose. To investigate patient characteristics, clinical features, common causative organisms, and visual acuity outcomes in endogenous endophthalmitis. Methods. This was a retrospective chart analysis of patients with endogenous endophthalmitis between January 2006 and December 2019. Collected data included basic patient characteristics, presenting symptoms, causative organisms, treatments, and 3-month and 1-year visual outcomes. Results. Twenty-nine eyes of 27 patients were included in the study. The mean age of the patients was 45.4 ± 19.9 years, and 63% were female. Visual acuity at presentation ranged from counting fingers to no light perception. Systemic comorbidities presented in 66.7% of the patients, the majority of which were related to diabetes mellitus (48.1%). The most common primary infection was a urinary tract infection. Positive blood cultures were identified in 48.1% of patients, and positive cultures from vitreous and aqueous samples were identified in 59.3% and 31.6% of eyes, respectively. Among all the specimens, Gram-positive bacteria were identified in 55.5%, Gram-negative bacteria in 22.2%, fungi in 14.8%, and mixed organisms in 7.4%. Among ocular specimens, 61.1% contained Gram-positive organisms, 16.7% contained Gram-negative organisms, and 22.2% contained fungi. Streptococcus spp. was the most common causative organism. From 29 eyes, 18 (62.1%) underwent vitrectomy, and 12 (42.9%) underwent either evisceration or enucleation. Positive vitreous culture was significantly associated with unfavorable final visual outcome. Final visual acuity ranged from 20/125 to no light perception. Although visual improvement at 3 months was significantly better in younger patients, this had no impact on final visual outcome at 1 year. Conclusion. Eyes with positive vitreous cultures had significantly poorer visual outcomes. Despite full treatment coverage, visual prognosis was extremely poor and the rates of blindness and evisceration/enucleation were still high.

scholarly journals Visual outcome of endogenous endophthalmitis in Thailand

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Preeyachan Lourthai ◽  
Pitipol Choopong ◽  
Dhanach Dhirachaikulpanich ◽  
Kunravitch Soraprajum ◽  
Warinyupa Pinitpuwadol ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Visual Outcome ◽  
Post Treatment ◽  
Endogenous Endophthalmitis ◽  
Infectious Episode ◽  
Hand Motion ◽  
Phthisis Bulbi ◽  
Causative Agents ◽  
Corneal Decompensation ◽  
The Mean

AbstractTo evaluate a 10-year visual outcome of endogenous endophthalmitis (EE) patients. A 10-year retrospective chart review of EE patients. Thirty-eight patients (40 eyes) were diagnosed with EE at the mean age of 42. Among the identifiable pathogens (71.1% culture positive), the causative agents were predominantly gram-negative bacteria (48.1%). The most common specie was Klebsiella pneumoniae (25.9%). About a quarter of the patients required surgical eye removal, and the remaining 45.7% had visual acuity (VA) worse than hand motion at one month after the infectious episode. The most common complication was ocular hypertension (52.5%). Poor initial VA was significantly associated with a worse visual outcome in the early post-treatment period (p 0.12, adjusted OR 10.20, 95% CI 1.65–62.96). Five patients continued to visit the clinic for at least ten years. One patient had gained his vision from hand motion to 6/7.5. Two patients had visual deterioration, one from corneal decompensation, and the other from chronic retinal re-detachment. Two patients developed phthisis bulbi, with either some VA perception of light or no light perception. Poor initial VA is the only prognostic factor of a poor early post-treatment visual outcome of EE.

scholarly journals Analysis of Clinical Characteristics of 19 Patients with Endophthalmitis Caused by Liver Abscess

2021 ◽  
Author(s):  
guangsen liu ◽  
Yue Li ◽  
Wei Wang ◽  
Lei Gao
Keyword(s):  
Visual Acuity ◽  
Liver Abscess ◽  
Diagnosis And Treatment ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Microbial Culture ◽  
Poor Vision ◽  
Ocular Symptoms ◽  
History Of ◽  
First Time

Abstract Objective: To analyze the clinical features, treatment, and prognosis of endophthalmitis caused by a liver abscess.Methods: All cases of endogenous endophthalmitis caused by a liver abscess in our hospital in the past 7 years were analyzed retrospectively. The data collected included age, sex, history of diabetes, initial and final vision, pathogen, course of the disease, treatment, and prognosis.Results: 21 eyes of 19 patients were complicated with liver abscess. The average age was 55.9 ±9.8 years old, including 10 males (52.6%) and 9 females (44.4%), 13 patients complicated with diabetes (71.4%), 14 patients (66.7%) first went to the ophthalmology department for diagnosis and treatment and 5 with hepatobiliary surgery (33.3%). 14 patients had a fever before onset, with an average fever time of 5.8 days. Before treatment, the duration of ocular symptoms was 7.71 ±6.68 days, 5.71 ±1.25 days for patients who go to ophthalmology for diagnosis and treatment for the first time, and 12.2 ±3.58 days for patients who go to other departments. After treatment, the average visual acuity of 21 eyes was 0.013, and the average best-corrected visual acuity was 0.79. In the 21 eyes, vitreous fluid culture was positive in 7 eyes (33.3%), all of which were Klebsiella pneumonia. Among the 14 patients with fever during hospitalization, 5 cases were positive for blood microbial culture, all of which were Klebsiella pneumonia. After vitrectomy, the average visual acuity was improved by 4.90 ±2.47 letters and that of patients without vitrectomy was-0.25±0.16letters. The visual acuity of patients who underwent postoperative visual was significantly better than that of patients without postoperative visual (P＜0.096). The visual acuity of patients without vitrectomy was significantly higher than that of patients without vitrectomy (P ＜0.01). 3 eyes (33.3%) of 9 eyes in the IVI group were removed because of uncontrolled inflammation, and 1 eye of 12 eyes in the PPV group was removed because of inflammation recurrence.Conclusion: The prognosis of endogenous endophthalmitis caused by liver abscess is generally poor, but early treatment can save part of the vision. The first visit non-ophthalmology department will delay the early diagnosis of the disease. Diabetes is an important risk factor for endogenous endophthalmitis and poor vision in patients with liver abscess. Klebsiella pneumonia is the main pathogen of intraocular infection. Vitrectomy combined with vitreous injection of antibiotics can improve the prognosis. A systematic and thorough treatment of a liver abscess is of great significance to prevent the recurrence of endophthalmitis in a liver abscess.

scholarly journals Bacterial and Fungal Endophthalmitis

2017 ◽  
Vol 30 (3) ◽  
pp. 597-613 ◽  
Author(s):  
Marlene L. Durand
Keyword(s):  
Intravitreal Injection ◽  
Systemic Infection ◽  
Visual Outcome ◽  
Diagnostic Techniques ◽  
Medical Emergency ◽  
Molecular Diagnostic ◽  
Endogenous Endophthalmitis ◽  
Molecular Diagnostic Techniques ◽  
Permanent Loss ◽  
Hematogenous Seeding

SUMMARY Endophthalmitis is a severe eye infection that may result in permanent loss of useful vision in the affected eye. Most cases are exogenous and occur as a complication of cataract surgery, an intravitreal injection, or penetrating ocular trauma. Endogenous endophthalmitis results from hematogenous seeding of the eye by bacteria or fungi, but bacteremia or fungemia may be transient and patients may present without symptoms of systemic infection. Nearly all endophthalmitis patients present with decreased vision, and some also have eye pain. Eye examination usually reveals a hypopyon and intraocular inflammation. Diagnosis is clinical, supported by cultures of the vitreous and/or aqueous or by blood cultures in some endogenous cases. Molecular diagnostic techniques have been used in research laboratories for pathogen identification in endophthalmitis and offer the possibility of rapid diagnosis, including in culture-negative cases. Intravitreal injection of antibiotics is the most important component of treatment; some cases also benefit from surgical debridement of the vitreous by a vitrectomy. The visual outcome depends partly on the pathogen: coagulase-negative staphylococcal endophthalmitis has a better prognosis than does streptococcal endophthalmitis, for example. Endophthalmitis is a medical emergency, and prompt diagnosis and treatment are essential for saving vision.

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