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Bryan Jones, Lisa Athwal, Marco Zarbin, Paul Langer, Neelakshi Bhagat; Pediatric Infectious Endophthalmitis: A Case Series. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1119.
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To describe the etiology, diagnosis, management, and outcomes of pediatric infectious endophthalmitis cases at University Hospital, Newark, NJ over 11 years, 2001-2011.
Retrospective series. Data were collected on demographics, presenting clinical findings, management, culture results, and visual and anatomic outcomes.
Seven cases of infectious pediatric endophthalmitis were identified in six patients. Two patients were male, and four were female. Mean presenting age was 6 years (range 4 weeks to 16 years). The most common etiology was trauma, accounting for 3 out of 7 cases (43%), of which one featured an intraocular foreign body. Two of 7 cases were caused by endogenous bacterial spread (29%), and 2 of 7 were secondary to bleb infection (29%). Patients presented most commonly with symptoms of pain (71%), photophobia (43%), and blurred vision (43%) and signs of vitritis (100%), anterior chamber fibrinous exudates (57%), conjunctival hyperemia (57%), chemosis (71%), and hypopyon (29%). All 3 trauma cases had uveal prolapsed in zone III. None presented with retinal detachment. Only one of three vitreous cultures was positive (33%) and grew Group B Streptococcus. Three cases underwent both pars plana vitrectomy (PPV) and intravitreal antibiotics (43%), and one only intravitreal antibiotics (14%). Best recorded visual acuity after resolution of infection was 20/400 in one patient, counts fingers in another, and no light perception in the remaining 5 eyes. One underwent primary enucleation (14%), one secondary enucleation (14%), and 2 became phthisical (29%).
Endophthalmitis is a rare but calamitous condition usually resulting in blindness. Our small series finds traumatic open globe injury as the most common cause of infectious endophthalmitis. Despite emergent treatment, patients are frequently left with no light perception in the affected eye.
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