Treatment of Postoperative Endophthalmitis

2014 ◽  
Vol 07 (02) ◽  
pp. 146
Author(s):  
Leopoldo Spadea ◽  
Keyword(s):  
Visual Outcome ◽  
Ocular Infection ◽  
Postoperative Endophthalmitis ◽  
Light Perception ◽  
Coagulase Negative Staphylococci ◽  
Therapeutic Success ◽  
Ocular Surgery ◽  
Gram Positive Bacteria ◽  
Initial Visual Acuity ◽  
Prompt Diagnosis

Endophthalmitis is a feared complication of trauma, surgical procedures, and septicemia. The rates of postoperative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Postoperative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of postoperative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withStaphyloccus aureus, enterococci,Bacillus, or Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating postoperative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub conjunctival, systemic, or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous in terms of the intravitreal antibiotic injection.

Treatment of Post-operative Endophthalmitis

2012 ◽  
Vol 06 (05) ◽  
pp. 261
Author(s):  
Leopoldo Spadea ◽  
Arianna Fiasca ◽  
◽  
Keyword(s):  
Visual Outcome ◽  
Ocular Infection ◽  
Light Perception ◽  
Coagulase Negative Staphylococci ◽  
Therapeutic Success ◽  
Ocular Surgery ◽  
Gram Positive Bacteria ◽  
Initial Visual Acuity ◽  
Prompt Diagnosis ◽  
Staphyloccus Aureus

The rates of post-operative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Post-operative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of post-operative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withstaphyloccus aureus,enterococci,Bacillusor Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating post-operative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub-conjunctival, systemic or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous with respect to the intravitreal antibiotic injection.

Treatment of Post-operative Endophthalmitis

2012 ◽  
Vol 06 (03) ◽  
pp. 149 ◽  
Author(s):  
Leopoldo Spadea ◽  
Arianna Fiasca ◽  
◽  
Keyword(s):  
Visual Outcome ◽  
Ocular Infection ◽  
Light Perception ◽  
Coagulase Negative Staphylococci ◽  
Therapeutic Success ◽  
Ocular Surgery ◽  
Gram Positive Bacteria ◽  
Initial Visual Acuity ◽  
Prompt Diagnosis ◽  
Staphyloccus Aureus

The rates of post-operative endophthalmitis have been low for many years, but recent reports suggest that this type of ocular infection may be on the rise. Fluctuations in the number of cases appear to correlate with the type of intraocular surgery performed. Post-operative endophthalmitis has been reported as a consequence of nearly every type of ocular surgery, but is most common following cataract surgery. Numerous reports have demonstrated that Gram-positive bacteria cause the vast majority of post-operative endophthalmitis cases. Coagulase-negative staphylococcal isolates are the most common. Most intraocular infections resulting from infection with coagulase-negative staphylococci can be treated with antibiotic and anti-inflammatory agents, resulting in restoration of partial or complete vision. However, the more virulent the bacterial strain, the more devastating the visual outcome. Intraocular infections withStaphyloccus aureus, enterococci,Bacillusor Gram-negative strains are often intractable, and blindness or loss of the eye itself is not uncommon. The therapeutic success of treating post-operative endophthalmitis depends largely on accurate and prompt diagnosis. Antibiotic therapy can be topical, sub-conjunctival, systemic or intravitreal. Vitrectomy must be reserved for patients who present with initial visual acuity of light perception. Only in these cases has vitrectomy been shown to be more advantageous with respect to the intravitreal antibiotic injection.

scholarly journals The Outcome of Vitrectomy in Acute Postoperative Endophthalmitis

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Sindy Boru Sembiring ◽  
Yulia Aziza ◽  
Gitalisa Andayani Adriono
Keyword(s):  
Visual Acuity ◽  
Clinical Diagnosis ◽  
Hand Movement ◽  
Case Series ◽  
Visual Outcome ◽  
Advanced Technology ◽  
Postoperative Endophthalmitis ◽  
Light Perception ◽  
Retrospective Case ◽  
Retrospective Case Series

Introduction: Twenty years ago, the results of Endophthalmitis Vitrectomy Study (EVS) were adapted worldwide as the standard management of endophthalmitis. The study suggested that there was no benefit of performing vitrectomy for acute postoperative endophthalmitis, unless for patients who presents with visual acuity of light perception. However, vitrectomy with advanced technology and technique has been changed rapidly in the last decades; therefore, we need to reconsider its role. We conducted a study and the purpose of our study was to describe the indications for vitrectomy and the outcomes in acute postoperative endophthalmitis at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Result: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Conclusion: An eight-year experience has taught us that vitrectomy offers better treatment outcome in the group with visual acuity of hand movement than those who only had visual acuity of light perception.

scholarly journals First Report of a Case of Ocular Infection Caused by Purpureocillium lilacinum in Poland

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1046
Author(s):  
Robert Kuthan ◽  
Anna K. Kurowska ◽  
Justyna Izdebska ◽  
Jacek P. Szaflik ◽  
Anna Lutyńska ◽  
...  
Keyword(s):  
Contact Lens ◽  
Pars Plana Vitrectomy ◽  
Penetrating Keratoplasty ◽  
Visual Outcome ◽  
Ocular Infection ◽  
Corneal Perforation ◽  
Purpureocillium Lilacinum ◽  
First Case ◽  
Pars Plana ◽  
Tof Ms

This report describes the first case of an ocular infection induced by Purpureocillium lilacinum in Poland. The patient was a 51-year-old immunocompetent contact lens user who suffered from subacute keratitis and progressive granulomatous uveitis. He underwent penetrating keratoplasty for corneal perforation, followed by cataract surgery due to rapid uveitic cataract. A few weeks later, intraocular lens removal and pars plana vitrectomy were necessary due to endophthalmitis. The patient was treated with topical, systemic, and intravitreal voriconazole with improvement; however, the visual outcome was poor. The pathogen was identified by MALDI-TOF MS.

scholarly journals Biosynthesis of the Unique Wall Teichoic Acid of Staphylococcus aureus Lineage ST395

mBio ◽  
2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Volker Winstel ◽  
Patricia Sanchez-Carballo ◽  
Otto Holst ◽  
Guoqing Xia ◽  
Andreas Peschel
Keyword(s):  
Staphylococcus Aureus ◽  
Cell Wall ◽  
Gene Transfer ◽  
Horizontal Gene Transfer ◽  
Biosynthesis Pathway ◽  
Glycerol Phosphate ◽  
Coagulase Negative Staphylococci ◽  
Content Type ◽  
Gram Positive Bacteria ◽  
Wall Teichoic Acids

ABSTRACT The major clonal lineages of the human pathogen Staphylococcus aureus produce cell wall-anchored anionic poly-ribitol-phosphate (RboP) wall teichoic acids (WTA) substituted with d-Alanine and N-acetyl-d-glucosamine. The phylogenetically isolated S. aureus ST395 lineage has recently been found to produce a unique poly-glycerol-phosphate (GroP) WTA glycosylated with N-acetyl-d-galactosamine (GalNAc). ST395 clones bear putative WTA biosynthesis genes on a novel genetic element probably acquired from coagulase-negative staphylococci (CoNS). We elucidated the ST395 WTA biosynthesis pathway and identified three novel WTA biosynthetic genes, including those encoding an α-O-GalNAc transferase TagN, a nucleotide sugar epimerase TagV probably required for generation of the activated sugar donor substrate for TagN, and an unusually short GroP WTA polymerase TagF. By using a panel of mutants derived from ST395, the GalNAc residues carried by GroP WTA were found to be required for infection by the ST395-specific bacteriophage Φ187 and to play a crucial role in horizontal gene transfer of S. aureus pathogenicity islands (SaPIs). Notably, ectopic expression of ST395 WTA biosynthesis genes rendered normal S. aureus susceptible to Φ187 and enabled Φ187-mediated SaPI transfer from ST395 to regular S. aureus. We provide evidence that exchange of WTA genes and their combination in variable, mosaic-like gene clusters have shaped the evolution of staphylococci and their capacities to undergo horizontal gene transfer events. IMPORTANCE The structural highly diverse wall teichoic acids (WTA) are cell wall-anchored glycopolymers produced by most Gram-positive bacteria. While most of the dominant Staphylococcus aureus lineages produce poly-ribitol-phosphate WTA, the recently described ST395 lineage produces a distinct poly-glycerol-phosphate WTA type resembling the WTA backbone of coagulase-negative staphylococci (CoNS). Here, we analyzed the ST395 WTA biosynthesis pathway and found new types of WTA biosynthesis genes along with an evolutionary link between ST395 and CoNS, from which the ST395 WTA genes probably originate. The elucidation of ST395 WTA biosynthesis will help to understand how Gram-positive bacteria produce highly variable WTA types and elucidate functional consequences of WTA variation.

scholarly journals Six-year epidemiological analysis of post traumatic endophthalmitis in a Brazilian hospital

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Luis Filipe Nakayama ◽  
Vinicius Campos Bergamo ◽  
Nilva Simeren Bueno de Moraes
Keyword(s):  
Visual Acuity ◽  
Foreign Body ◽  
Penetrating Trauma ◽  
Onset Time ◽  
Intraocular Foreign Body ◽  
Time Interval ◽  
Light Perception ◽  
Initial Visual Acuity ◽  
Open Globe ◽  
Better Than

Abstract Background To evaluate the epidemiology of endophthalmitis cases related to ocular trauma, including visual acuity during and 1 year after trauma, source of trauma and method of treatment. Methods A retrospective study analyzed the epidemiological data of patients with a clinical presentation of endophthalmitis after ocular penetrating trauma between January 2012 and January 2017 at Escola Paulista de Medicina/UNIFESP, a hospital in São Paulo, SP, Brazil. Results A total of 453 patients with antecedent open globe trauma were evaluated, among these, 30 patients with suspected endophthalmitis. All patients were male. The time interval between trauma and ophthalmological evaluation and collection of vitreous and aqueous material was 1 day in 36.66%, 2–7 days in 43.44%, 7–14 days in 10% and more than 15 days in 10% of patients; 66.66% had positive cultures. 11 patients had intraocular foreign body. One year after trauma, visual acuity was classified as no light perception (NLP) in 33.33%, light perception in 6.66%, hand motion in 13.33%, counting fingers in 13.33%, and better than 20/400 in 20% of patients. Considering presence of intraocular foreign body, initial visual acuity and symptoms onset time, only initial visual acuity showed as better prognostic factor in final visual acuity. Conclusion Endophthalmitis is a severe ocular inflammatory condition that may lead to irreversible vision loss. Initially only one patient had visual acuity of NLP, but after 1 year, 33% showed visual acuity of NLP, and only 20% had visual acuity better than 20/400, what is consistent with a severe infection with a guarded prognosis. The high incidence of endophthalmitis after ocular penetrant trauma justifies distinct treatment and greater attention.

scholarly journals Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

2020 ◽  
Author(s):  
Marta Ziaja-Sołtys ◽  
Magdalena Kołodziejczyk ◽  
Beata Rymgayłło-Jankowska ◽  
Dominika Wróbel-Dudzińska ◽  
Ewa Suchodoła-Ratajewicz ◽  
...  
Keyword(s):  
Dry Eye ◽  
Meibomian Gland ◽  
Sjögren Syndrome ◽  
Dry Eye Syndrome ◽  
Ocular Infection ◽  
Sjogren Syndrome ◽  
Corneal Perforation ◽  
Therapeutic Success ◽  
Immune Systems

Abstract Purpose Demodex mites infestation, typically asymptomatic, is a problem for patients with weakened immune systems because it often takes the form of symptomatic, massive infection. The Demodex mites play an important role in the occurrence of a range of eye surface diseases such as Demodex blepharitis, Meibomian gland dysfunctions, conjunctivitis and corneal changes. The ocular infection is closely related to the systemic invasion. Our goal was to minimize infestation and alleviate the symptoms of massive demodicosis so as to prevent further damage to the cornea. Methods Our research note involves a 61-year old woman diagnosed with secondary Sjögren syndrome due to rheumatoid arthritis. On the background of the autoimmune disease, corneal perforation of the left eye occurred that was cured by surgery. Then during the follow-up visit the patient was found (microscopically) massively infected with Demodex mites and the developed symptoms were particularly severe. Results Adequate dry eye syndrome and massive demodicosis therapy significantly reduced the number of Demodex mites and improved the patient’s condition. Conclusion We would like to draw the attention of the physicians of different specialties that special care should be taken with respect to the therapy of dry eye syndrome and ocular demodicosis in patients with immunological disorders to achieve therapeutic success and avoid particularly dangerous consequences of these diseases.

scholarly journals Transcalvarial and Transdural Involvement of Skull Actinomycosis with Recurrence

2019 ◽  
Vol 08 (03) ◽  
pp. 185-187
Author(s):  
Kramadhari Harshith ◽  
Krishnan Nagarajan ◽  
Andi Sadayandi Ramesh ◽  
Debasis Gochhait
Keyword(s):  
Immune System ◽  
Human Body ◽  
Sudden Onset ◽  
Diabetic Woman ◽  
Gram Positive Bacteria ◽  
Malignant Lesions ◽  
Histopathologic Analysis ◽  
Prompt Diagnosis

AbstractActinomycosis is caused by anaerobic gram-positive bacteria of Actinomyces genus, generally found as commensals in the human body and infection occurs when the immune system is compromised. We present the case of a 35-year-old diabetic woman, who presented with headache and sudden onset of left-sided weakness apart from scalp swelling, which on imaging showed transcalvarial transdural involvement, and subsequent surgical debridement and histopathologic analysis confirmed actinomycosis. Follow-up showed recurrence of the lesion at the same site following a period of remission. Calvarial involvement of actinomycosis is rare and can mimic even neoplastic or malignant lesions, hence requiring prompt diagnosis, treatment with surgery, and long-term antibiotic treatment to prevent complications.

scholarly journals Comparative Surveillance Study of Telavancin Activity against Recently Collected Gram-Positive Clinical Isolates from across the United States

2008 ◽  
Vol 52 (7) ◽  
pp. 2383-2388 ◽  
Author(s):  
Deborah C. Draghi ◽  
Bret M. Benton ◽  
Kevin M. Krause ◽  
Clyde Thornsberry ◽  
Chris Pillar ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Clinical Isolates ◽  
Surveillance Study ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Serious Infections ◽  
Wide Range ◽  
Vancomycin Resistant

ABSTRACT Telavancin is an investigational, rapidly bactericidal lipoglycopeptide antibiotic that is being developed to treat serious infections caused by gram-positive bacteria. A baseline prospective surveillance study was conducted to assess telavancin activity, in comparison with other agents, against contemporary clinical isolates collected from 2004 to 2005 from across the United States. Nearly 4,000 isolates were collected, including staphylococci, enterococci, and streptococci (pneumococci, beta-hemolytic, and viridans). Telavancin had potent activity against Staphylococcus aureus and coagulase-negative staphylococci (MIC range, 0.03 to 1.0 μg/ml), independent of resistance to methicillin or to multiple agents. Telavancin activity was particularly potent against all streptococcal groups (MIC90s, 0.03 to 0.12 μg/ml). Telavancin had excellent activity against vancomycin-susceptible enterococci (MIC90, 1 μg/ml) and was active against VanB strains of vancomycin-resistant enterococci (MIC90, 2 μg/ml) but less active against VanA strains (MIC90, 8 to 16 μg/ml). Telavancin also demonstrated activity against vancomycin-intermediate S. aureus and vancomycin-resistant S. aureus strains (MICs, 0.5 μg/ml to 1.0 μg/ml and 1.0 μg/ml to 4.0 μg/ml, respectively). These data may support the efficacy of telavancin for treatment of serious infections with a wide range of gram-positive organisms.

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