5.A Case of Pantoea Endophthalmitis.
Na Eun LEE ; In Young CHUNG ; Jong Moon PARK
Korean Journal of Ophthalmology 2010;24(5):318-321
A previously healthy 50-year-old man was transferred to our hospital for evaluation of acute inflammation in his right eye after ocular trauma while using a grass mower. Slit lamp examination showed 1 mm-length full thickness corneal laceration without leakage, 4+ cells and inflammatory membrane in the anterior chamber, 10% hypopyon, posterior synechiae formation, and cataract change. Upon orbital computerized tomography, a metallic intraocular foreign body in the lens was indentified. Vitrectomy, phacoemulsification, foreign body removal, anterior chamber irrigation, and intravitreal antibiotics injections of vancomycin and ceftazidime were performed. In a culture of humor from the anterior chamber grew Pantoea species. More procedures were performed, including intravitreal antibiotics injection of ceftazidime. Upon administering a course of intravenous ceftazidime, fortified ceftazidime and moxifloxacin eye drops, and oral prednisolone, the patient improved.
Anti-Infective Agents/administration & dosage
;
Diagnosis, Differential
;
Endophthalmitis/diagnosis/*microbiology/therapy
;
Enterobacteriaceae Infections/diagnosis/*microbiology/therapy
;
Humans
;
Lens Implantation, Intraocular
;
Male
;
Middle Aged
;
Pantoea/*isolation & purification
;
Republic of Korea
6.A Case of Postoperative Endophthalmitis by Extended-spectrum Beta-lactamase-producing Escherichia coli.
Korean Journal of Ophthalmology 2012;26(4):306-308
A 75-year-old female was transferred to our clinic three days after uneventful phacoemulsification with intraocular lens (IOL) implantation in the right eye that had been carried out at a local clinic. Under the diagnosis of postoperative endophthalmitis, the patient underwent pars plans vitrectomy, IOL explantation, silicone oil tamponade, and intravitreal antibiotic injection. Even after the procedure, the patient's condition was further aggravated, and extended-spectrum beta-lactamase-producing Escherichia coli were identified on bacterial identification test. Although meropenem was applied locally and systemically, the patient had no-light perception visual acuity.
Aged
;
Anti-Bacterial Agents/therapeutic use
;
Endophthalmitis/drug therapy/*microbiology
;
Escherichia coli/*isolation & purification
;
Female
;
Humans
;
Phacoemulsification
;
Postoperative Complications/diagnosis/*microbiology
;
Visual Acuity
;
beta-Lactamases
7.Case Report of Acremonium Intraocular Infection after Cataract Extraction.
Soo Geun JOE ; Jongyoon LIM ; Joo Yong LEE ; Young Hee YOON
Korean Journal of Ophthalmology 2010;24(2):119-122
A 64-year-old woman was referred to our clinic for the treatment of chronic uveitis in her left eye, which had started two weeks after an uncomplicated cataract extraction. She was treated with topical steroids with an initially good response, yet she subsequently developed severe inflammation and plaque-like material around the intraocular lens, despite continuous steroid therapy. She underwent pars plana vitrectomy, smear and culture of the aqueous and vitreous fluids, and intravitreal antibiotic injection under the impression of Propionibacterium acne (P. acne) endophthalmitis. As a result of the smear and culture of the vitreous fluid identified as an Acremonium species, she was treated with intravenous amphotericin B injections for five days, followed by oral voriconazole administration. During the post-operative 18-month follow-up, she was stable without significant relapse of uveitis. In this case, the best correction of visual acuity was an improvement from 20/40 to 20/20.
Acremonium/*isolation & purification
;
Antifungal Agents/therapeutic use
;
*Cataract Extraction
;
Endophthalmitis/drug therapy/*microbiology
;
Eye Infections, Fungal/drug therapy/*microbiology
;
Female
;
Humans
;
Middle Aged
8.Clinical Review of Endogenous Endophthalmitis in Korea: A 14-Year Review of Culture Positive Cases of Two Large Hospitals.
Kyu Sik CHUNG ; Young Keun KIM ; Young Goo SONG ; Chang Oh KIM ; Sang Hoon HAN ; Bum Sik CHIN ; Nam Su GU ; Su Jin JEONG ; Ji Hyeon BAEK ; Jun Yong CHOI ; Hyo Youl KIM ; June Myung KIM
Yonsei Medical Journal 2011;52(4):630-634
PURPOSE: To identify the clinical features and outcomes of endogenous endophthalmitis in Korea. MATERIALS AND METHODS: We reviewed 18 patients with endogenous endophthalmitis at 2 Korean hospitals, treated over a 14 year period between January 1993 and December 2006. RESULTS: The comorbidities observed in these cases were diabetes mellitus and liver cirrhosis. The most common pathogens, which were found in 7 patients each (38.9%), were Klebsiella pneumonia and Pseudomonas aeruginosa. All patients were treated with systemic antibiotics and fortified topical antibiotics. A surgical approach including vitrectomy was performed in 9 cases (50.0%). The prognosis was generally poor, and visual acuity improved slightly in 6 patients (33.3%). CONCLUSION: In this study, diabetes mellitus and Klebsiella pneumonia showed a close relationship with endogenous endophthalmitis, respectively. Endogenous endophthalmitis is a serious risk to sight and careful attention to establishing the diagnosis and management may decrease the ocular morbidity.
Aged
;
Diabetes Complications/*epidemiology/microbiology
;
Endophthalmitis/complications/*epidemiology/microbiology
;
Female
;
Humans
;
Incidence
;
Klebsiella pneumoniae/isolation & purification
;
Liver Cirrhosis/*complications/epidemiology/microbiology
;
Male
;
Middle Aged
;
Pseudomonas aeruginosa/isolation & purification
;
Republic of Korea/epidemiology
;
Retrospective Studies
9.A Case of Bilateral Endogenous Pantoea Agglomerans Endophthalmitis with Interstitial Lung Disease.
Susie SEOK ; Young Jun JANG ; Seung Woo LEE ; Ho Chang KIM ; Gyoung Yim HA
Korean Journal of Ophthalmology 2010;24(4):249-251
We here in report a case of bilateral endogenous endophthalmitis caused by Pantoea agglomerans (P. agglomerans) in a patient who had interstitial lung disease and was treated with oral corticosteroids. A 72-year-old man presented with decreased visual acuity in both eyes nine days after he received oral corticosteroids. He had marked uveitis, cataracts, and vitreous opacities. Cultures were taken of blood, aqueous humor, and vitreous. We initially suspected a fungal etiology and treated him with antifungal drugs; however, the intraocular disease progressed without improvement. Vitreous culture was positive for P. agglomerans. The patient underwent pars plana vitrectomy with cataract surgery bilaterally, followed by a 2-week course of antibiotics. The final visual acuity was 20/25 in the right eye and 20/200 in the left eye. This is the first report of bilateral endogenous endophthalmitis caused by P. agglomerans in Korea; it is also the first case reported outside of the United States.
Aged
;
Anti-Bacterial Agents/therapeutic use
;
Endophthalmitis/complications/*microbiology/therapy
;
Enterobacteriaceae Infections/complications/*microbiology/therapy
;
Eye Infections, Bacterial/complications/*microbiology/therapy
;
Follow-Up Studies
;
Humans
;
Lung Diseases, Interstitial/*complications
;
Male
;
Pantoea/*isolation & purification
;
Visual Acuity
;
Vitrectomy
10.The Results of Evisceration with Primary Porous Implant Placement in Patients with Endophthalmitis.
Young Gun PARK ; Ji Sun PAIK ; Suk Woo YANG
Korean Journal of Ophthalmology 2010;24(5):279-283
PURPOSE: To assess the results and long-term prognosis of evisceration with primary porous implant placement in patients with endophthalmitis. METHODS: A retrospective study was conducted to review the files of 27 patients (29 eyes) with endophthalmitis who underwent evisceration with primary porous implant placement from January 1997 to December 2007 at St. Mary's Hospital and Kangnam St. Mary's Hospital. The mean follow-up period was 12.24 months (range, 3 to 89 months) and the mean age of the patients was 63.6 years (range, 33 to 89 years). RESULTS: During the surgical procedure, primary implant placement was successfully completed, and any postoperative infection or inflammation rapidly resolved in all 27 patients (29 eyes). One of two porous implant materials was used. Hydroxyapatite was inserted in 14 eyes and Medpor was inserted in 15 eyes. Delayed implant exposure was noted in 1 eye, which was treated by inserting a hydroxyapatite implant 18 months after the first surgery. This was well treated by a preserved scleral graft. Implant infection was noted in 1 other eye at 20 days after the first surgery. All other minor complications healed without sequelae. CONCLUSIONS: Evisceration with primary porous implant placement as the treatment for recalcitrant endophthalmitis resulted in rapid resolution of any infection and inflammation. Implant exposure and infection occurred in only 2 eyes, and these problems were well treated without long-term sequelae. Therefore, evisceration with primary porous implant placement is a treatment option for patients with endophthalmitis.
Adult
;
Aged
;
Aged, 80 and over
;
Endophthalmitis/microbiology/*surgery
;
*Eye Evisceration
;
Female
;
Humans
;
Male
;
Middle Aged
;
*Orbital Implants
;
Porosity
;
Prognosis
;
Retrospective Studies
;
Treatment Outcome