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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The submitted paper deals with an epidemic of severe postoperative panophthalmitis, its development, course, causes and sequelae incl. epidemiological characteristics. The disease developed in four patients 40 hours after operation of cataract. Despite treatment all four patients developed septicaemia and therefore the affected eyeballs were eviscerated. From smears of the conjunctival sac of the affected patients and from the contents of the eviscerated eyeball Proteus mirabilis and Enterobacter cloaceae were cultivated. The authors draw attention to the epidemiological association with the eye lotion BSS which was used from which Proteus mirabilis and E. coli were cultivated and with the Ringer solution from which Enterobacter cloaceae and Klebsiella pneumoniae were cultivated. An epidemiological analysis of the epidemic was made and provisions were defined to rule out its recurrence.
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PMID:[Panophthalmitis as a nosocomial infection]. 136 55

Five of 16 patients who had uncomplicated cataract extraction with intraocular lens (IOL) implantation within a 2.5 day period experienced increased anterior segment inflammation on their first postoperative day. Four of these five patients had phacoemulsification and one a planned extracapsular cataract extraction. All had posterior chamber IOL implantation in the capsular bag. In all patients, this anterior segment inflammation cleared with topical steroids over two to three weeks with no evident residual ocular effects. A careful search for the possible cause of the inflammation showed that the ultrasonic cleaning bath and Weck liquid detergent used to clean the instruments contained Klebsiella pneumoniae bacteria. Further investigation demonstrated the presence of a heat-stable endotoxin produced by the bacteria. We postulate that endotoxin remaining on the instruments after cleaning and sterilization caused this postoperative anterior segment inflammation. To the best of our knowledge, these are the first reported cases caused by contaminated liquid detergent.
J Cataract Refract Surg 1992 Jan
PMID:Postoperative inflammation following cataract extraction caused by bacterial contamination of the cleaning bath detergent. 173 55

Since the antibiotic era, endophthalmitis has been a rare complication of bacterial septicemia. The authors report hereby 3 cases of endogenous bacterial endophthalmitis. Both eyes were involved in one case. Causative bacteria were identified in blood. Cultures were positive respectively for Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae. All patients received intravenous antibiotherapy, once intravitreal antibiotic was injected. Clinical manifestations were three times panophthalmitis with dramatic course. In one case, only the anterior segment was involved. The course became complicated with a cataract, but the patient finally recovered. Although several clinical types with distinct prognoses can be defined, endogenous bacterial endophthalmitis remains a devastating situation. Treatment is controversial because of the uncertainty about the value of intravitreal antibiotics and vitreous surgery.
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PMID:[Endogenous bacterial endophthalmitis. Report of 3 cases]. 229 3

Two grams of ceftazidime was given to 25 patients before cataract surgery. Mean aqueous humor concentrations of 2.8, 3.2, 3.39, and 1.94 micrograms/mL were observed 30 minutes and 1, 2, 4, and 6 hours, respectively, after administration of the drug. These concentrations are many times higher than the minimum inhibitory concentration (MIC) of ceftazidime against 90% ( MIC90 ) of isolates of Escherichia coli, Klebsiella sp, Proteus mirabilis, and indole-positive Proteus sp. The peak aqueous humor level was also equivalent to or slightly higher than the MIC90 for Pseudomonas aeruginosa.
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PMID:Ceftazidime concentrations in human aqueous humor. 637 45

An 82-year-old woman underwent complicated cataract surgery with subsequent endophthalmitis. She presented with a unique purulent collection with ciliary body involvement and Klebsiella pneumoniae was grown on culture. Klebsiella is a rare cause of endophthalmitis and ciliary body involvement has not previously been reported.
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PMID:Endophthalmitis post complicated cataract surgery associated with Klebsiella pneumoniae. 2021 54

A 45-year-old woman developed a spontaneous flap-margin-related corneal ulcer 11 years after the original laser in situ keratomileusis (LASIK) procedure. Two enhancements had been performed; the most recent was 3 years prior to presentation. Cultures were positive for a heavy growth of Klebsiella oxytoca. The ulcer responded clinically to topical treatment with fortified cefazolin. Eighteen days after presentation, the infiltrate had resolved and the cornea had fully epithelialized. To our knowledge, this is the first report of post-LASIK infectious keratitis caused by K oxytoca.
J Cataract Refract Surg 2011 Aug
PMID:Late-onset Klebsiella oxytoca flap-margin-related corneal ulcer following laser in situ keratomileusis. 2178 1

We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae in an immunocompetent patient. A 73-year-old man with acute epididymitis who had no history of diabetes mellitus developed endogenous endophthalmitis. The patient underwent anterior vitrectomy and intracapsular cataract extraction with intravitreal injections of both vancomycin and ceftazidime. After the surgery, he was treated with topical and intravenous antibiotics; however, the left eye perforated and was enucleated. Culture from vitreous biopsy specimens grew as K. pneumoniae, which was positive for both magA and rmpA. K. pneumoniae should be considered as a pathogen that can cause severe endogenous endophthalmitis in patients with urinary tract infection. The severity of the disease may be related to the virulence genes.
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PMID:Case of endogenous endophthalmitis caused by Klebsiella pneumoniae with magA and rmpA genes in an immunocompetent patient. 2299 35

Endophthalmitis means bacterial or fungal infection inside the eye involving the vitreous and/or aqueous humors. Most cases are exogenous and occur after eye surgery, after penetrating ocular trauma, or as an extension of corneal infection. An increasing number of cases are occurring after intravitreal injections of anti-vascular endothelial growth factor (VEGF) medications. Endophthalmitis may also be endogenous, arising from bacteraemic or fungaemic seeding of the eye. The infected eye never serves as a source of bacteraemia or fungaemia, however. The most common pathogens in endophthalmitis vary by category. Coagulase-negative staphylococci are the most common causes of post-cataract endophthalmitis, and these bacteria and viridans streptococci cause most cases of post-intravitreal anti-VEGF injection endophthalmitis, Bacillus cereus is a major cause of post-traumatic endophthalmitis, and Staphylococcus aureus and streptococci are important causes of endogenous endophthalmitis associated with endocarditis. In Taiwan and other East Asian nations, Klebsiella pneumoniae causes most cases of endogenous endophthalmitis, in association with liver abscess. Endogenous fungal endophthalmitis in hospitalized patients is usually caused by Candida species, particularly Candida albicans. Acute endophthalmitis is a medical emergency. The most important component of treatment is the intravitreal injection of antibiotics, along with vitrectomy in severe cases. Systemic antibiotics should be used in cases of endogenous endophthalmitis and exogenous fungal endophthalmitis, but their role in exogenous bacterial endophthalmitis is uncertain. Repeated intravitreal injections of antibiotics may be necessary if there is no response to the initial therapy. Many eyes that receive prompt and appropriate treatment will recover useful vision.
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PMID:Endophthalmitis. 2343 28

In this retrospective case series, we studied the predisposing factors, causative organisms, clinical spectrum, and outcomes of 12 cases of culture-proven infectious scleritis. Nine of 12 patients had a history of preceding trauma (surgical or accidental). Past surgical history included small-incision cataract surgery (4), pterygium surgery (1), and trabeculectomy (1). Six patients had multifocal scleral abscesses due to Pseudomonas, Klebsiella, or Nocardia. Only 2 patients retained useful vision (>6/18). A poor visual acuity at presentation usually resulted in a worse visual outcome (P = 0.005). Four eyes developed phthisis. The addition of surgical intervention did not result in a significantly better visual outcome than medical management alone (P = 0.209), but resulted in a higher globe preservation rate (P = 0.045). Therefore, we concluded that infection must be ruled out in cases of scleritis with preceding history of trauma, and aggressive surgical intervention improves the anatomical outcome but does not change the visual outcome.
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PMID:Infectious scleritis: clinical spectrum and management outcomes in India. 2421 12

Klebsiella is a Gram-negative bacterium that causes different types of health care-associated infections including pneumonia, bloodstream infections, surgical site infections and meningitis. We report here a case of Klebsiella pneumoniae meningitis in a patient with diabetes mellitus and Hansen's disease. A middle-aged man with a known case of diabetes mellitus and Hansen's disease presented with the complaints of blurred vision in the left eye and the patient was found to have cataract. Patient was operated for cataract and Intraocular lens implanted. Patient developed headache and vomiting on the 4th post-operative day. Lumbar puncture was carried out and gram stain of cerebrospinal fluid showed Gram-negative bacilli in the direct smear and culture yielded a heavy growth of K. pneumoniae. The patient was treated with antimicrobials according to the susceptibility pattern. He initially showed improvement but later on developed altered sensorium and hypotension. Patient succumbed to infection in spite of all medical attention.
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PMID:Fatal Klebsiella pneumoniae meningitis in a patient with diabetes mellitus and Hansen's disease. 2473 55


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