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D.M. Yoder, H.W. Flynn, Jr., I.U. Scott, D. Miller; Endophthalmitis Caused by Haemophilus influenza . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1836.
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Purpose: To investigate the clinical settings, treatment strategies, antibiotic sensitivities, and visual acuity outcomes associated with endophthalmitis caused by Haemophilus influenza. Methods: A retrospective, noncomparative, consecutive case series including all patients treated for H. influenza endophthalmitis at a single institution between January 1, 1980 and December 31, 2001. Results: The study included 17 eyes of 17 patients with a median age of 68 years (range, 6 months to 83 years). The median follow-up was 26 months (range, 2 months to 15 years). Clinical settings included post-cataract surgery (8), bleb-associated (6), post-pars plana vitrectomy (1), post-secondary IOL insertion (1), and post-suture removal (1). The median interval between surgery/intervention and presentation with endophthalmitis was 47 days (range, 2 days to 21 years). Presenting visual acuity was hand motions or better in 8 (47%) eyes and 5/200 or better in 2 eyes (12%). Final visual acuity was 5/200 or better in 7 eyes (41%); 2 eyes were enucleated. The initial treatment included vitreous tap in 10 (59%) eyes and PPV in 7 (41%) eyes. The organisms were sensitive to at least one of the initial antibiotics administered in all cases. In vitro testing of the H. influenza isolates revealed that aminoglycosides, cephalosporins, fluoroquinolones, and carbapenems are usually effective treatment options while vancomycin and penicillins are variably ineffective. Conclusion: Endophthalmitis caused by H. influenza was identified most often following cataract and glaucoma surgery. It is generally associated with poor visual outcomes despite treatment with an appropriate intravitreal antibiotic regimen.
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