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 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 54-year-old female was admitted to our hospital because of a spiking fever, right hypochondriac pain, right orbital pain and visual disturbance. Before admission she was treated with systemic antibiotics infusion for a diagnosis of liver abscess at the other hospital and the liver abscess almost diminished for a while. With the diagnosis of liver abscess and endophthalmitis, liver drainage and evisceration were carried out. The culture of pus from the eye and liver yielded K. pneumoniae. After liver drainage, evisceration, and direct injection of antibiotics into the eye, inflammatory findings tended to improve. Seven cases of metastatic K. pneumoniae endophthalmitis have been reported so far in Japan. The cases had liver abscess as the primary disease and 3 cases had bilateral endophthalmitis. Five cases with liver abscess survived except one who died of sepsis, but unfortunately, all cases became blind in the affected eyes. The prognosis of bacterial endophthalmitis, especially associated with K. pneumoniae liver abscess, is poor and as the outcome could appear to depend on time when treatment is started, a more aggressive diagnostic approach is required. Moreover systemic antibiotic infusion alone is inadequate for treatment of liver abscess and endophthalmitis, and liver drainage, evisceration and intravitreal injection of antibiotics must be given in early stage.
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PMID:[A case of liver abscess associated with endophthalmitis caused by Klebsiella pneumoniae]. 845 Feb 78

While most ocular infections are benign, others can be associated with devastating visual consequences. Most patients present with either ocular discharge, visual symptoms or a red or painful eye. The primary care physician is usually the first to evaluate these patients. We have separated ocular infections into 3 groups. Infections affecting the cornea and conjunctiva often present with eye pain and a red eye; noninfectious aetiologies can have a similar presentation. Infections inside the eye (endophthalmitis) often have devastating consequences. They usually occur following penetrating ocular trauma or after intraocular surgery. Prompt referral to an ophthalmologist is crucial. Infections in the soft tissue surrounding the eye (ocular adnexa and orbit) can involve the eye indirectly and can spread from the orbit into the brain. The purpose of this article is to review ocular infections and current opinion regarding treatment. A general guideline should be that the approach to treatment be governed by the severity of symptoms and the magnitude of possible consequences. Mild external infections can be typically treated empirically. Severe conjunctivitis, and any corneal infection, require aggressive management, often including cultures and broad spectrum antibiotics; cultures are often used to guide treatment. Devastating vision loss can occur, even with aggressive management. Preseptal cellulitis in adults and older children can be managed conservatively with oral antibiotics if the orbit and optic nerve are not involved and the patient is otherwise healthy. Orbital or optic nerve involvement, on the other hand, demands orbital imaging and more aggressive intervention. Patients who have had recent surgery are at risk for developing endophthalmitis. Complaints of pain or a red eye must be taken very seriously. These patients must be considered to have an intraocular infection until it can be ruled out, and should be aggressively managed by a physician trained in eye diseases and surgery.
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PMID:Common ocular infections. A prescriber's guide. 889 65

We reviewed the charts of 21 patients who underwent penetrating keratoplasty and transscleral fixation of a posterior chamber lens. One lens was sutured in an aphakic eye and 20 lenses were sutured after removal of an anterior chamber lens. Postoperative follow-up averaged 13 months (2-39 months). Visual acuity improved in 20 patients (95%) and remained the same in 1 patient (5%). Postoperative visual acuity was less than 0.1 in 5 patients (23.8%), 0.1 to 0.33 in 14 patients (66.7%) and better than 0.33 in 2 patients (9.5%). Twelve patients (57.1%) expressed a substantial reduction in ocular pain, 7 patients (33.3%) had no pain either before or after the operation, 2 patients (9.5%) expressed no reduction in pain. No cases of endophthalmitis, choroidal hemorrhage or retinal detachment were found. In one case, the sutured lens was dislocated without disturbing vision. Intraocular pressure increased in 3 of 9 patients with preoperative glaucoma. New-onset glaucoma developed in 1 patient. We find transscleral fixation of a posterior chamber lens to be an acceptable procedure in penetrating keratoplasty with IOL implantation where capsular support is inadequate for conventional implantation of a posterior chamber lens.
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PMID:Penetrating keratoplasty and transscleral fixation of posterior chamber lens. 901 84

1. Researchers have recently introduced the term "blebitis" to describe a limited form of bleb-related infection (with infection and inflammation limited to the bleb and the peri-bleb area, with or without anterior chamber involvement) in contrast to the more classic form of endophthalmitis. 2. Bleb-related endophthalmitis is the virulent form of bleb-related infection in which patients present with rapidly worsening visual acuity, redness, and pain with diffuse conjunctival congestion, opalescent blebs (with or without epithelial defects) with intense fibrin and/or hypopyon in the anterior chamber, and florid vitritis. 3. Blebitis and bleb-related endophthalmitis are two distinct bleb-related infections, each with different presentations, prognoses, and outcomes. It is important that clinicians recognize this and treat patients accordingly.
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PMID:Bleb infections: clinically different courses of "blebitis" and endophthalmitis. 946 Apr 18

The authors describe two patients who underwent pars plana vitrectomy for nonclearing vitreous hemorrhage. Both patients had severe pain, increased intraocular pressure, and orbital swelling. The anterior chamber became flat in a phakic eye. The infection progressed rapidly, and ultimately evisceration was required in both cases. The presence of a flat anterior chamber in gas-filled, phakic eyes and a severe orbital inflammatory reaction in the early postoperative period should alert the physician to the possibility of endophthalmitis.
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PMID:Endophthalmitis in eyes following vitrectomy. 979 54

A renal abscess, caused by Serratia marcescens with endophthalmitis in a 68-year-old diabetic female, is described. Endophthalmitis presented with visual loss, conjunctiva injection and lid edema with eye pain. Right costovertebral knocking pain was also noted. Sonography and computed tomography of abdomen showed a 4 cm hypoechoic lesion in the middle portion of the right kidney with marginal enhancement after contrast media injection. Percutaneous abscess drain was performed. Pus culture from the drain tube revealed S. marcescens, yet, vitreous cultures yielded no growth, which was ascribed to previous antibiotics use. Although vitrectomy, fortified eye drops, intravitreal and systemic intravenous antibiotics were administered, the visual function was still lost. To our knowledge, this is the first reported case of S. marcescens renal abscess complicated with endophthalmitis.
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PMID:Serratia marcescens renal abscess with endophthalmitis: a case report. 1049 66

Infectious endophthalmitis can be caused by organisms from the environment entering the eye after ocular surgery (62%) or after penetrating ocular trauma (20%) (exogenous endophthalmitis), or can result from hematogeneous spread of organisms to the eye (8%) (endogenous endophthalmitis). Endophthalmitis is the most dreaded ocular infection, and carries one of the worst visual prognoses of all ocular infections. The symptoms of endophthalmitis are blurred vision, redness, and pain. The signs include conjunctival hyperemia, anterior chamber and vitreous cell, hypopyon, lid edema, chemosis, corneal edema, reduced red reflex, and afferent pupillary defect. The main treatment is intravitreal antibiotics used in conjunction with subconjunctival, topical, and intravenous antibiotics and corticosteroids.
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PMID:Infectious Endophthalmitis. 1109 85

A 37-year-old patient with bilateral keratoconus underwent a perforating cornea transplantation after acute onset of pain and hydrops of the right cornea. One day after operation endophthalmitis developed, caused by a viridans streptococcus. Hyper-IgE syndrome was suspected because of the patient's crude facial features. His medical history brought up additional symptoms of this disease. IgE levels were extremely elevated (7320 kU/l), the eosinophil count was slightly raised (0.25 x 10(9)/l). The patient was treated with several local antibiotics but his vision was only light perception at the time of discharge from the hospital. This case illustrates how an usually successful operation may have a disastrous outcome in case of late diagnosis of the hyper-IgE syndrome. The hyper-IgE syndrome can be recognized by the characteristic facial features in combination with the often extensive (juvenile) medical history with infections, and by elevated serum IgE levels. As patients with the hyper-IgE syndrome are extremely susceptible to develop infections, prophylactic antibiotic therapy is indicated in surgical procedures.
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PMID:[Loss of an eye due to hyper-IgE syndrome after corneal transplantation]. 1119 64

Endophthalmitis is a serious postoperative complication of phacoemulsification surgery. Administration of a subconjunctival antibiotic is a common method of prophylaxis in the United Kingdom and other countries. Injection of subconjunctival cefuroxime can be very painful, especially after phacoemulsification under topical anesthesia. Our experience is that this could be the only painful step in the entire operation. We evaluated a technique in which buffered lignocaine is injected into the subconjunctival space before the antibiotic injection. The technique was used in 46 eyes (46 patients) that had phacoemulsification under topical anesthesia. Eighty-seven percent of patients found the injection painless, 6.5% reported that the pain was very negligible, and 6.5% reported a moderate degree of pain.
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PMID:Topical anesthesia for phacoemulsification and painless subconjunctival antibiotic injection. 1122 81

Removal of the eye may be necessary after severe ocular trauma, to control pain in a blind eye, to treat some intraocular malignancies, in endophthalmitis unresponsive to medical therapy, and for cosmetic improvement of a disfigured eye. The choice of procedure to accomplish this is best made by an informed patient. Enucleation and evisceration can each achieve the desired goals, but several factors must be considered in choosing the most appropriate procedure.
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PMID:Enucleation versus evisceration. 1221 60


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