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J.A. Dovich, S.H. Lee, J. Fan; A 19–Year Retrospective Review of Treated Cases of Endogenous Endophthalmitis . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5276.
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To review predisposing diseases, sources of infection, causative organisms, management, and visual outcomes of endogenous endophthalmitis.
All cases of endophthalmitis treated at Loma Linda University Medical Center from January 1, 1987 through December 1, 2005 were retrospectively reviewed (n=163). Medical records were thoroughly reviewed and all cases of endogenous endophthalmitis were selected for inclusion in this study (n=13; eyes=19).
Predisposing systemic conditions include diabetes mellitus, renal dialysis, immune deficiency, and malignancy. Sources of infection included infected hospital tubing (31%), urinary tract infections (21%), endocarditis (15%), gastrointestinal abscesses (15%), and other (18%). Forty–six percent of the patients developed bilateral endophthalmitis. The majority of cases were fungal (46%), and vitreous cultures were positive in 57% of those cases. Staphylococcus aureaus accounted for 26% of the cases, 60% of which were culture proven. Other etiologies included Klebsiella and Nocardia. The majority of cases were managed with intravitreal antibiotics and/or vitrectomies (94%). Only three eyes had final visual acuities of 20/100 or better. The remaining eyes had visual outcomes ranging from count fingers to no light perception (42%), or were not reported (42%).
In our study, 47% of the cases reviewed were culture proven and these results support a high incidence of fungal endogenous endophthalmitis. Furthermore, visual prognosis was found to be poor in the majority of patients. Outcome was most affected by the extent of the infection, and how soon treatment was initiated.
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