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E.C. Mavrofrides, H.W. Flynn Jr., I.U. Scott, D. Miller; Endophtalmitis Caused by Proteus Species . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1838.
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Purpose: To investigate the clinical settings, treatment strategies, antibiotic sensitivities, and visual acuity outcomes for endophthalmitis caused by Proteus species. Methods: A retrospective, noncomparative, consecutive case series including all patients treated at a single institution for endophthalmitis caused by Proteus species between January 1, 1977 and December 31, 2001. Results: This study included 10 eyes of 10 patients with a median age of 74 years (range, 63 to 85 years). The median follow-up was 3 months (range, 2 weeks to 5 years). Clinical settings included post-extracapsular cataract extraction (6), post-phacoemulsification cataract extraction (1), post-intracapsular cataract extraction (1), and post-pars plana vitrectomy (2). Median interval between surgery and diagnosis with endophthalmitis was 4 days (range, 2 to14 days). Seven of the patients were light perception at the time of presentation, two were hand motions, and one was 4/200. All patients received intraocular antibiotics after initial diagnosis. Three of the patients also received intraocular dexamethasone. Intraocular injection was combined with vitrectomy in 4 patients and intraocular tap in 6 patients (1 anterior chamber and 5 vitreous). Six patients received additional doses of intraocular antibiotics, and three patients underwent secondary surgical intervention. Nine of the isolates grew Proteus mirabilis and one grew Proteus morganii. The organism was sensitive to the initial antibiotic administered in all cases. Final visual acuity was better than 20/200 in only 3 eyes. Four patients had a final visual acuity of no light perception, and 2 of these patients required enucleation for a blind, painful eye. Conclusions: As with many other gram negative organisms, endophthalmitis caused by Proteus species is associated with poor visual outcomes despite treatment with appropriate intraocular antibiotics.
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