| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Klinische Monatsblätter für Augenheilkunde | ||||
| Publisher: | GEORG THIEME VERLAG KG | ||||
| Place of Publication: | STUTTGART | ||||
| Volume: | 236 | ||||
| Number of Issue or Book Chapter: | 10 | ||||
| Page Range: | pp. 1208-1214 | ||||
| Date: | 2019 | ||||
| Institutions: | Medicine > Lehrstuhl für Augenheilkunde | ||||
| Identification Number: |
| ||||
| Keywords: | BACTERIAL ENDOPHTHALMITIS; POSTOPERATIVE ENDOPHTHALMITIS; PATHOGENESIS; PROPHYLAXIS; FEATURES; endogenous endophthalmitis; sepsis; ocular infection; general disease | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 48186 |
Web of ScienceAbstract
Background Endogenous endophthalmitis is a rare and severe inflammation of the eye in the context of a systemic infectious disease, which can lead to the loss of the affected eye in the worst case. Material and Methods In a 5-year period, 20 eyes were treated for endogenous endophthalmitis and evaluated retrospectively. Evaluation parameters were epidemiological data, causes, concomitant ...
Abstract
Background Endogenous endophthalmitis is a rare and severe inflammation of the eye in the context of a systemic infectious disease, which can lead to the loss of the affected eye in the worst case. Material and Methods In a 5-year period, 20 eyes were treated for endogenous endophthalmitis and evaluated retrospectively. Evaluation parameters were epidemiological data, causes, concomitant diseases, assessment of the pathogen spectrum, therapy and visual acuity. Results 13.2% (n = 20/152; 20 eyes of 17 patients) of all endophthalmitis cases were of endogenous origin. In 15% (n = 3/ 20) of the cases, bilateral endogenous endophthalmitis was present. The cause for the endophthalmitis was generalised sepsis in 9 of 17 cases, an infection of the urogenital tract in 2 of 17 cases and endocarditis and liver abscess in 1 of 17 cases, respectively. In 4 of 17 cases, no primary foci were detected. Eight of 17 patients suffered from diabetes mellitus, 6 of 17 from renal insufficiency and 2 of 17 from malignancies, pneumonia or rheumatism. Two of 17 patients had had an organ transplantation, 15 of 17 suffered from cardiovascular diseases, 3 of 17 were immunosuppressed and 2 of 17 reported drug abuse. Four of 17 infections were caused by streptococci, 3 of 17 by Candida, 2 of 17 by herpes viruses and 1 of 17 by Staphylococcus aureus and Bacillus cereus. No pathogen could be found in 5 cases. The time interval between the onset of symptoms and diagnosis and the beginning of the therapy was 4 days (min.: 1 day; max.: 39 days). This was significantly longer in comparison with other causes of endophthalmitis (p < 0.001). Median visual acuity (VA) was 2.0 logMAR (n = 19/20) at the first presentation. One month and three months after initiation of the therapy VA was 1.3 logMAR (both n = 15/ 20), VA was 0.1 logMAR (n = 9/20) at the one year follow-up. Retinal detachment occurred in 2 of 20 eyes and recurrence of the endophthalmitis in 1 of 20 eyes within the one year follow-up, 5 of 17 patients died. Enucleation was never necessary. Conclusion Endogenous endophthalmitis is often misdiagnosed due to a severe underlying non-ophthalmological disease. Delayed presentation with consequent late initiation of therapy is an unresolved problem, because colleagues from other fields are often unexperienced in diagnosing the ocular infection. This is also a cause of the already poor visual prognosis. Ophthalmologists can usually only influence the choice of the proper therapy.
Metadata last modified: 03 Sep 2021 09:44
Altmetric