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Salvetti AP, Pellegrini M, Bottoni F, Staurenghi G. Endogenous bacterial endophthalmitis masquerading as an intraocular tumor. Saudi J Ophthalmol 2015; 30:71-4. [PMID: 26949365 PMCID: PMC4759503 DOI: 10.1016/j.sjopt.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/19/2015] [Accepted: 11/10/2015] [Indexed: 11/26/2022] Open
Abstract
A 40-year-old female patient referred for a possible intraocular tumor was found to have an endogenous bacterial endophthalmitis in her right eye. Fundus examination revealed an amelanotic dome shaped choroidal mass and an exudative retinal detachment. Enhanced Depth Imaging-Optical Coherence Tomography (EDI-OCT), fundus autofluorescence (FAF) and ultrasounds were suggestive of a possible choroidal melanoma. A multimodal imaging approach and a thorough anamnesis were instrumental in establishing the correct diagnosis.
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Affiliation(s)
- Anna Paola Salvetti
- Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Italy
| | - Marco Pellegrini
- Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Italy
| | - Ferdinando Bottoni
- Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Italy
| | - Giovanni Staurenghi
- Eye Clinic, Department of Clinical Science "Luigi Sacco", Sacco Hospital, University of Milan, Italy
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Sadiq MA, Hassan M, Agarwal A, Sarwar S, Toufeeq S, Soliman MK, Hanout M, Sepah YJ, Do DV, Nguyen QD. Endogenous endophthalmitis: diagnosis, management, and prognosis. J Ophthalmic Inflamm Infect 2015; 5:32. [PMID: 26525563 PMCID: PMC4630262 DOI: 10.1186/s12348-015-0063-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 10/28/2015] [Indexed: 02/08/2023] Open
Abstract
Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.
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Affiliation(s)
- Mohammad Ali Sadiq
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Muhammad Hassan
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Aniruddha Agarwal
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Salman Sarwar
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Shafak Toufeeq
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Mohamed K Soliman
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA. .,Department of Ophthalmology, Assiut University Hospital, Assiut University, Assiut, Egypt.
| | - Mostafa Hanout
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Yasir Jamal Sepah
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Diana V Do
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
| | - Quan Dong Nguyen
- Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, 3902 Leavenworth Street, Omaha, NE, 68105, USA.
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Donzel E, Reyes-Gomez E, Chahory S. Endogenous endophthalmitis caused by Enterococcus faecalis in a cat. J Small Anim Pract 2013; 55:112-5. [PMID: 24028653 PMCID: PMC7166967 DOI: 10.1111/jsap.12136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A three‐year‐old male neutered domestic shorthair cat was presented for loss of vision associated with hyperthermia, lethargy and anorexia. Ophthalmic examination revealed a bilateral panuveitis. Cytological examination of aqueous and vitreous humours was performed and revealed a suppurative inflammation associated with numerous cocci. Enterococcus faecalis was identified by bacterial culture from aqueous and vitreous humour. No primary infection site was identified. Active uveitis resolved after systemic antibiotic therapy, but the vision loss was permanent. To the authors’ knowledge, this is the first reported case of endogenous bacterial endophthalmitis secondary to E. faecalis infection in a cat.
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Affiliation(s)
- E Donzel
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Recherche en Ophtalmologie Vétérinaire, Maisons-Alfort Cedex, France
| | - E Reyes-Gomez
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité d'embryologie, d'Histologie et d'Anatomie Pathologique, Maisons-Alfort Cedex, France
| | - S Chahory
- Université Paris-Est, Ecole Nationale Vétérinaire d'Alfort, Unité de Recherche en Ophtalmologie Vétérinaire, Maisons-Alfort Cedex, France
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Safneck JR. Endophthalmitis: A review of recent trends. Saudi J Ophthalmol 2012; 26:181-9. [PMID: 23960990 PMCID: PMC3729827 DOI: 10.1016/j.sjopt.2012.02.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 02/28/2012] [Indexed: 11/19/2022] Open
Abstract
Endophthalmitis is a feared complication of trauma, surgical procedures and septicemia. Although uncommon, its potential for significant visual loss is well recognized. Especially over the past decade, complicated surgeries and medical techniques have increased and seriously ill patients are being sustained in ever increasing numbers. New pathogens are being recognized and known ones reclassified thanks to advances in molecular analysis. Continuously evolving PCR methodologies also add a new dimension to the diagnosis of infectious endophthalmitis. As well, medical literature is now truly international, encompassing studies from around the world that expand our understanding of ocular infectious disease. This report reviews some of these changes as they relate to endophthalmitis and particularly to the spectrum of organisms involved.
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Affiliation(s)
- Janice R. Safneck
- Departments of Pathology and Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada
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Labelle AL, Hamor RE, Townsend WM, Mitchell MA, Zarfoss MK, Breaux CB, Thomasy SM, Hall T. Ophthalmic lesions in neonatal foals evaluated for nonophthalmic disease at referral hospitals. J Am Vet Med Assoc 2012; 239:486-92. [PMID: 21838586 DOI: 10.2460/javma.239.4.486] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine types and frequency of ophthalmic lesions detected in neonatal foals evaluated for nonophthalmic disease at 3 veterinary referral hospitals and to investigate associations between systemic and ophthalmic diseases in these foals. DESIGN Prospective cross-sectional study. ANIMALS 70 foals < 30 days old. PROCEDURES Complete ophthalmic examinations were performed. Signalment, clinical signs, mentation during ophthalmic examination, results of clinicopathologic tests, and diagnosis of systemic disease were recorded. Descriptive data analysis including a χ(2) test for associations was performed. RESULTS Most foals (39/70 [55.7%]) with systemic disease had ≥ 1 ophthalmic lesion detected. Of the 39 foals with ophthalmic disease, 24 (61.5%) had potentially vision-threatening lesions. Clinically important abnormalities included conjunctival hyperemia or episcleral injection (30/70 [42.9%]), uveitis (18/70 [25.7%]), ulcerative keratitis (13/70 [18.6%]), nonulcerative keratitis (10/70 [14.3%]), entropion (8/70 [11.4%]), retinal hemorrhage (8/70 [11.4%]), and cataract (6/70 [8.6%]). Foals with sepsis were significantly more likely to have uveitis than were those without sepsis. Foals with sepsis and uveitis were also significantly less likely to survive to discharge than were foals that had sepsis without uveitis. Acquired ophthalmic disease (detected in 37/70 [52.9%] foals) was significantly more common than congenital ophthalmic disease (detected in 9/70 [12.9%]). CONCLUSIONS AND CLINICAL RELEVANCE Ophthalmic lesions were detected in 55.7% of neonatal foals with systemic disease. Acquired ophthalmic disease was more commonly detected than congenital ophthalmic disease. Foals with sepsis were more likely to have uveitis than were foals without sepsis. A complete ophthalmic examination is indicated in neonatal foals evaluated for systemic disease.
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Affiliation(s)
- Amber L Labelle
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois Urbana-Champaign, Urbana, IL 61802, USA.
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