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Shetty NHG, Shetty MS, Saha S, Shetty SK, Hussain M. Prosthetic Management of an Eviscerated Eye of a 13-month-old Patient: A Case Report. Int J Clin Pediatr Dent 2024; 17:89-91. [PMID: 38559861 PMCID: PMC10978500 DOI: 10.5005/jp-journals-10005-2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background On account of loss of eye following Rubella infection, a 13-month-old baby girl patient required a maxillofacial prosthesis to restore her facial esthetics and social health as she grows. Case presentation The process of prosthesis fabrication began at the time of enucleation where a conformer was given. Post healing the procedure was completed in a span of 2 days taking adequate trials and cross references for the like-like appearance of the prosthesis. Conclusion A heat-cure acrylic resin based prosthetic eye was delivered with adequate instructions on the insertion and removal and hygiene maintenance given to the care providers. How to cite this article Shetty NHG, Shetty MS, Saha S, et al. Prosthetic Management of an Eviscerated Eye of a 13-month-old Patient: A Case Report. Int J Clin Pediatr Dent 2024;17(1):89-91.
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Affiliation(s)
- Naresh HG Shetty
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
| | - Mallika S Shetty
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
| | - Snigdha Saha
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
| | - Sanath Kumar Shetty
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
| | - Murtaza Hussain
- Department of Prosthodontics, Yenepoya Dental College, Yenepoya (Deemed to be University), Mangaluru, Karnataka, India
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Rodriguez A, Ahmed K, Tiwari N, Ramasubramanian A. Orbital cellulitis with panophthalmitis and scleral necrosis - a case report. BMC Ophthalmol 2023; 23:452. [PMID: 37957590 PMCID: PMC10641989 DOI: 10.1186/s12886-023-03193-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Orbital cellulitis is common in young children and is often secondary to coexisting sinus disease. Coexisting orbital cellulitis and panophthalmitis is a rare clinical event and usually occurs secondary to trauma or from an endogenous source. CASE PRESENTATION A febrile 2-year-old male presented with periorbital inflammation and exudative retinal detachment. Imaging showed acute sinusitis and extensive orbital cellulitis. Because of progressive scleral thinning, the patient underwent enucleation. CONCLUSION We present a case of concurrent orbital cellulitis, panophthalmitis, and scleral necrosis in an immunocompetent pediatric patient. Timely intervention is important to prevent life threatening complications with the rare occurrence of coexistent orbital cellulitis and panophthalmitis.
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Affiliation(s)
- Aurora Rodriguez
- Phoenix Children's Hospital, 1920 E Cambridge Ave, 85,006-1464, Phoenix, AZ, United States of America
| | - Kamran Ahmed
- Phoenix Children's Hospital, 1920 E Cambridge Ave, 85,006-1464, Phoenix, AZ, United States of America
| | - Nishant Tiwari
- Phoenix Children's Hospital, 1920 E Cambridge Ave, 85,006-1464, Phoenix, AZ, United States of America
| | - Aparna Ramasubramanian
- Phoenix Children's Hospital, 1920 E Cambridge Ave, 85,006-1464, Phoenix, AZ, United States of America.
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Chelvaraj R, Thamotaran T, Yee CM, Fong CM, Zhe NQ, Azhany Y. The invasive Klebsiella pneumoniae syndrome: Case series. J Taibah Univ Med Sci 2022; 17:332-339. [PMID: 35592799 PMCID: PMC9073889 DOI: 10.1016/j.jtumed.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022] Open
Abstract
This case-series aims to report three cases of endogenous endophthalmitis due to invasive Klebsiella pneumoniae syndrome. Case 1 A 34-year-old lady who was admitted for pneumonia developed painful blurring of vision and redness in the right eye (RE) for one week. An examination of the RE revealed visual acuity (VA) of light perception (PL) with positive relative afferent pupillary defect (RAPD), proptosis, and restriction of extraocular movement with hypopyon. The patient was treated for RE panophthalmitis with a lung abscess and was started on systemic and topical antibiotics. The vitreous tap culture grew Klebsiella pneumoniae. Despite treatment, the patient's condition deteriorated, and evisceration was undertaken. Case 2 A 38-year-old lady presented with a acute onset of RE pain associated with blurred vision and redness for two days, and fever for one week. RE VA was hand movement with a positive RAPD and anterior chamber cells of 2+. A B-scan revealed a dome-shaped subretinal mass with exudative retinal detachment. The patient was treated for RE panophthalmitis complicated by a basal ganglia abscess. The urine and vitreous tap cultures grew Klebsiella pneumoniae. She responded to high-dose intravenous and intravitreal antibiotics. Unfortunately, her RE became phthisical. Case 3 A 70-year-old lady presented with painless blurring of vision over the RE. The blood and urine cultures grew Klebsiella pneumoniae. RE VA was PL, and she was treated for endogenous endophthalmitis. The vitreous culture grew Klebsiella pneumoniae. Unfortunately, the RE became phthisical.
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Affiliation(s)
- Radtthiga Chelvaraj
- Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
| | - Tinesh Thamotaran
- Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
| | - Cheong M. Yee
- Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Jalan Hospital, Ipoh, Malaysia
| | - Chong M. Fong
- Department of Ophthalmology, Hospital Raja Permaisuri Bainun, Jalan Hospital, Ipoh, Malaysia
| | - Ngoo Q. Zhe
- Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
| | - Yaakub Azhany
- Department of Ophthalmology and Visual Sciences, School of Medical Sciences, Universiti Sains Malaysia, Malaysia
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Takesue A, Asada Y, Ooya H, Yokoyama T. Blowout fracture-associated orbital cellulitis progressing to panophthalmitis: a case report. BMC Ophthalmol 2021; 21:390. [PMID: 34758776 PMCID: PMC8579522 DOI: 10.1186/s12886-021-02153-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parvimonas micra is known as a causative agent of chronic periodontal disease. This Gram-positive obligate anaerobic coccus was cultured from the ocular surface of blowout fracture-related orbital cellulitis progressing to panophthalmitis. CASE PRESENTATION The patient was a woman in her fifties who had panic disorder and subsequently was a victim of domestic violence. These factors led to delayed consultation. At the initial visit to an ophthalmologist, the ocular surface of the right eye was covered with pus. Swelling of the upper and lower eyelids prevented the eyelid from closing and exophthalmos, severe corneal ulcer, panophthalmitis, and no light perception were observed. Head computed tomography revealed an old blowout fracture and chronic sinusitis with orbital cellulitis. P. micra were isolated from culture of pus samples from the sinus and from the ocular surface. CONCLUSIONS There is a possibility that P. micra invaded the orbit via the fragile bony site and caused orbital cellulitis, severe corneal ulcer, and panophthalmitis that required enucleation. In cases of coexisting old blowout fracture and chronic sinusitis, the chronic sinusitis should be treated as quickly as possible.
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Affiliation(s)
- Atsuhide Takesue
- Department of Ophthalmology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Yosuke Asada
- Department of Ophthalmology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Hiroki Ooya
- Department of Ophthalmology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Toshiyuki Yokoyama
- Department of Ophthalmology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
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Hassanin F, Khawjah D, Elkhamary S, Al Hussain H. Renal abscesses and endogenous endophthalmitis due to hypermucoviscous hypervirulent Klebsiella pneumoniae (HVKP). IDCases 2021; 24:e01130. [PMID: 33996464 PMCID: PMC8094904 DOI: 10.1016/j.idcr.2021.e01130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/17/2021] [Accepted: 04/17/2021] [Indexed: 10/25/2022] Open
Abstract
We describe a diabetic patient with left eye endogenous endophthalmitis due to hypervirulent hypermucoviscous Klebsiella pneumoniae (HKVP) originating from right renal abscesses. A rare source of HVKP causing endogenous endophthalmitis. Despite treatment with intravenous ceftazidime and pars plana vitrectomy, the patient required evisceration of the left eye. A high index of suspicion for endogenous endophthalmitis and awareness of the virulence and potential antibiotic resistance of HVKP strains in the community is needed to avoid vision and life-threatening consequences.
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Affiliation(s)
- Fadi Hassanin
- King Khaled Eye Specialty Hospital, Riyadh, Saudi Arabia.,Department of Ophthalmology, College of Medicine, Jeddah University, Jeddah, Saudi Arabia
| | - Dareen Khawjah
- Department of Ophthalmology, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Chkheidze R, Evers BM, Cavuoti D, Merritt J, Hogan RN. Bilateral Acanthamoeba Panophthalmitis: A rare and unique case. Am J Ophthalmol Case Rep 2020; 20:100970. [PMID: 33117918 PMCID: PMC7581876 DOI: 10.1016/j.ajoc.2020.100970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/02/2020] [Accepted: 10/11/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose To describe a unique case of bilateral Acanthamoeba panophthalmitis in a 65-year-old male resulting in bilateral enucleation. Observation A 65-year-old man presented with a 10-year history of bilateral uveitis and scleritis, complicated by cataracts. He had undergone phacoemulsification with posterior chamber intraocular lens implantation in both eyes, left corneal transplant and pars plana vitrectomy, all without improvement in his vision and pain. Due to complete loss of vision and severe pain in his both eyes, the patient underwent bilateral enucleation. Pathologic examination of both eyes revealed severe acute, chronic, and granulomatous inflammation with abundant scar formation. Multiple large pre-retinal, choroidal, and vitreal cavitary lesions in both eyes were filled with necrotic debris, containing both Acanthamoeba trophozoites and cysts. These findings were consistent with a well-developed, bilateral Acanthamoeba panophthalmitis. Conclusions and importance This unique case represents the first ever reported bilateral Acanthamoeba panophthalmitis and illustrates the extreme complication of ocular Acanthamoeba infection.
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Affiliation(s)
- Rati Chkheidze
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Bret M Evers
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.,Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Dominick Cavuoti
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - James Merritt
- Oculoplastic Associates of Texas, Dallas, TX, 75231, USA
| | - R Nick Hogan
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.,Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
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Ono T, Abe K, Mori Y, Nejima R, Iwasaki T, Aihara M, Miyata K. Escherichia coli Panophthalmitis after Pecking by a Great Egret ( Ardea alba). Case Rep Ophthalmol 2020; 11:466-472. [PMID: 32999677 PMCID: PMC7506268 DOI: 10.1159/000509340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022] Open
Abstract
We report a case of open globe injury caused by Ardea albapecking that resulted in Escherichia colipanophthalmitis. A woman in her 70s complaining of ocular pain was referred to our hospital because her right eye had been pecked by an A. alba2 days earlier. Visual acuity in her right eye was reduced to light sensation. The right conjunctiva became hyperemic and edematous with swelling of the right upper eyelid. The upper side of the right cornea was densely cloudy with focal defect. Ultrasonography showed a thick sclera and choroid-like structure. Pathological investigation of a scraped sample from the infected site revealed gram-negative rods; E. coli was isolated. She had fever with elevated serum C-reactive protein levels and leukocytosis confirmed by laboratory examination. Topical levofloxacin and cefmenoxime and intravenous fosfomycin and aspoxicillin were initiated, but the right cornea melted near the perforated site with leakage of the eyeball contents on the next day. We decided to perform eye evisceration because of difficulty in controlling corneal melting and panophthalmitis. Her general state recovered the day after surgery. Orbital cellulitis improved gradually with normal C-reactive protein levels and white blood cell counts. As ocular injury caused by birds could become severe and cause ocular infection and visual dysfunction, it is important to exercise caution in the vicinity of wild birds, especially when they are aggressive.
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Affiliation(s)
- Takashi Ono
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan.,Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kentaro Abe
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Yosai Mori
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Ryohei Nejima
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Takuya Iwasaki
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
| | - Makoto Aihara
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazunori Miyata
- Department of Ophthalmology, Miyata Eye Hospital, Miyazaki, Japan
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Breazzano MP, Tooley AA, Godfrey KJ, Iacob CE, Yannuzzi NA, Flynn HW. Candida auris and endogenous panophthalmitis: clinical and histopathological features. Am J Ophthalmol Case Rep 2020; 19:100738. [PMID: 32462100 PMCID: PMC7240712 DOI: 10.1016/j.ajoc.2020.100738] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/24/2020] [Accepted: 05/06/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To report an unusual case of endogenous panophthalmitis involving Candida auris and describe its clinical and histopathological features. FINDINGS A 30 year-old man with history of human immunodeficiency virus, polysubstance abuse, syphilis, and recently treated pneumonia presented with polymicrobial endogenous panophthalmitis. Two separate ocular specimens confirmed simultaneous Pseudomonas aeruginosa and Candida auris involvement. Histopathological analysis demonstrated fulminant polymorphonuclear infiltration of all ocular tissue layers. Despite aggressive management including two intravitreal injections and enucleation, the patient died, ultimately after receiving care at four neighboring urban medical centers. CONCLUSIONS AND IMPORTANCE Candida auris has been a recently and increasingly described pathogen leading to mortality in metropolitan hospitals worldwide. To the authors' knowledge, Candida auris has not previously been reported with endophthalmitis or panophthalmitis. Future cases may be expected with the reported rise in Candida auris. A high suspicion of its contribution to panophthalmitis could be warranted early in the evaluation and management of profoundly immunocompromised patients, particularly those who have had sequential care at multiple neighboring metropolitan hospitals.
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Affiliation(s)
- Mark P. Breazzano
- Lenox Hill Hospital, Northwell Health, New York, NY, USA
- Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
| | - Andrea A. Tooley
- Lenox Hill Hospital, Northwell Health, New York, NY, USA
- Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
- Department of Ophthalmology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
- Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA
| | - Kyle J. Godfrey
- Lenox Hill Hospital, Northwell Health, New York, NY, USA
- Department of Ophthalmology, Columbia University Medical Center, New York-Presbyterian Hospital, New York, NY, USA
- Department of Ophthalmology, New York University School of Medicine, New York, NY, USA
- Department of Ophthalmology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA
| | - Codrin E. Iacob
- Departments of Ophthalmology and Pathology, New York Eye & Ear Infirmary of Mount Sinai, New York, NY, USA
| | - Nicolas A. Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA
| | - Harry W. Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, USA
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Abstract
A 70 year old man presented with systemic signs of toxic epidermal necrolysis (TEN) following consumption of diclofenac tablets for a prodromal illness a week back. Ophthalmic evaluation showed no perception of light in both eyes along with lid edema, total corneal sloughing, and pus-filled anterior chamber. An amniotic membrane transplant was planned but within a few hours, both eyes developed panophthalmitis with restricted extraocular movements and mild proptosis and had to be eviscerated. This is perhaps the first case showing such devastating sequelae of TEN.
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Chaparro Tapias TA, Rangel Gualdron CM, Rodriguez HA, Rodriguez LM, Flores de Los Reyes L, Sánchez España JC. Bilateral enucleation due to multi-bacterial fulminant endogenous panophthalmitis. Arch Soc Esp Oftalmol (Engl Ed) 2020; 95:34-37. [PMID: 31767407 DOI: 10.1016/j.oftal.2019.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/01/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
The case is presented of a 62 year-old woman with a rapid, progressive bilateral decrease in visual acuity and panuveitis with orbital cellulitis. She was also in poor general condition, with emesis and fever. Septicaemia due to Klebsiella pneumoniae and bilateral endogenous panophthalmitis were diagnosed. The ocular infection quickly progressed to sclerokeratitis and bilateral perforation despite broad spectrum systemic antibiotic management, and eventually the patient required bilateral enucleation. Microbiological cultures of the surgical pieces identified Klebsiella pneumoniae and Candida magnoliae. To our knowledge, this is the third published case that required bilateral enucleation or evisceration due to endogenous panophthalmitis, and the first case of endogenous ocular infection caused by Candida magnoliae.
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Affiliation(s)
- T A Chaparro Tapias
- Departamento de Cirugía Plástica Ocular, Oncológica y Órbita, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - C M Rangel Gualdron
- Departamento de Cirugía Plástica Ocular, Oncológica y Órbita, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - H A Rodriguez
- Departamento de Cirugía Plástica Ocular, Oncológica y Órbita, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia; Departamento de Oftalmología, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | - L M Rodriguez
- Departamento de Cirugía Plástica Ocular, Oncológica y Órbita, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Santander, Colombia
| | - L Flores de Los Reyes
- Departamento de Oftalmología, Hospital General de Granollers, Granollers, Barcelona, España.
| | - J C Sánchez España
- Departamento de Oftalmología, Hospital General de Granollers, Granollers, Barcelona, España
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Breazzano MP, Jonna G, Nathan NR, Nickols HH, Agarwal A. Endogenous Serratia marcescens panophthalmitis: A case series. Am J Ophthalmol Case Rep 2019; 16:100531. [PMID: 31508534 DOI: 10.1016/j.ajoc.2019.100531] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 07/24/2019] [Accepted: 07/30/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose – Two rare and unusual cases of endogenous panophthalmitis from Serratia marcescens are presented with mechanisms for infection explored. Observations – The first patient had history of intravenous drug use (IVDU) without any medical implants. The second patient, in addition to IVDU, had a history of end-stage renal disease with upper extremity arteriovenous fistula graft infection from Serratia marcescens confirmed by wound culture. One patient had a history of licking the needles prior to IV drug injection. Clinical exam in both cases revealed light perception vision, relative afferent pupillary defect, periorbital edema with limited extraocular motility, and hypopyon in the affected eyes. Cultures from the anterior chamber aspirate were positive for Serratia marcescens in the first case and demonstrated Gram-negative rods in the second. Attempted vitreous aspiration was unsuccessful at obtaining specimens. Computed tomography demonstrated orbital fat stranding without abscess, and histopathology showed intense neutrophilic infiltration in all layers of enucleated specimen in case one. Conclusions and Importance Needle licking may be an underappreciated mechanism for endogenous endophthalmitis in intravenous drug users. This report includes the first case in the literature, to authors’ knowledge, of non-nosocomial endogenous Serratia marcescens panophthalmitis with orbital cellulitis. The second case illustrates a rare consequence of the rise in arteriovenous fistula placement and dialysis across the United States, which may predispose to future cases of endogenous Serratia marcescens endophthalmitis. This series supports previous observations of Serratia marcescens endogenous endophthalmitis exhibiting a generally poor visual prognosis.
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12
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Hassman LM, Chung MM, Gonzalez M, Bessette AP. Herpetic Panophthalmitis: A Diagnostic Dilemma. Ocul Immunol Inflamm 2018; 28:116-118. [PMID: 30444434 DOI: 10.1080/09273948.2018.1546404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To describe an uncommon presentation of ocular infection caused by human herpes simplex virus 2 (HSV-2).Methods: Case report.Results: A 32-year-old female with no prior history of mucocutaneous herpesvirus infection presented with a minimally painful hypertensive granulomatous panophthalmitis and optic neuropathy that was initially suspected to be orbital cellulitis. Her disease progressed despite antibiotic and steroid treatment, and HSV-2 was ultimately identified in the vitreous.Conclusion: Although rare, ocular infection by human herpesvirus can present as a panophthalmitis. The case is discussed in the context of two previously reported cases of herpes simplex panophthalmitis, as well panophthalmitis caused by varicella zoster virus.
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Affiliation(s)
- L M Hassman
- Ophthalmology, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | - M M Chung
- Ophthalmology, University of Rochester David and Ilene Flaum Eye Institute, Rochester, New York, USA
| | - M Gonzalez
- Ophthalmology, University of Rochester David and Ilene Flaum Eye Institute, Rochester, New York, USA
| | - A P Bessette
- Ophthalmology, University of Rochester David and Ilene Flaum Eye Institute, Rochester, New York, USA
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13
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Guedira G, Taright N, Blin H, Fattoum T, Leroy J, El Samad Y, Milazzo S, Hamdad F. Clostridium perfringens panophthalmitis and orbital cellulitis: a case report. BMC Ophthalmol 2018; 18:88. [PMID: 29631556 PMCID: PMC5892009 DOI: 10.1186/s12886-018-0751-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 03/23/2018] [Indexed: 11/23/2022] Open
Abstract
Background Clostridium perfringens is an uncommon pathogen in endophthalmitis, causing rapid destruction of ocular tissues. Clostridium perfringens infection typically occurs after penetrating injury with soil-contaminated foreign bodies. Case report Here, we describe the case of a 17-year-old male who sustained a penetrating injury with a metallic intraocular foreign body and who rapidly developed severe C. perfringens panophthalmitis with orbital cellulitis. He was managed by systemic and intravitreal antibiotics, resulting in preservation of the globe, but a poor visual outcome. Conclusion Clostridial endophthalmitis secondary to penetrating injuries is a fulminant infection, almost always resulting in loss of the globe in the case of advanced infection. When feasible, early vitrectomy and intravitreal antibiotics should be considered in patients with penetrating eye injuries with contaminated foreign bodies.
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Affiliation(s)
- Ghita Guedira
- Ophthalmology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Nabil Taright
- Ophthalmology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Hélène Blin
- Ophthalmology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Thameur Fattoum
- Ophthalmology Department, Beauvais Hospital, Beauvais, France
| | - Jordan Leroy
- Clinical Bacteriology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Youssef El Samad
- Infectious diseases Department, Amiens-Picardie University Hospital, Amiens, France
| | - Solange Milazzo
- Ophthalmology Department, Amiens-Picardie University Hospital, Amiens, France
| | - Farida Hamdad
- Clinical Bacteriology Department, Amiens-Picardie University Hospital, Amiens, France. .,Centre de Biologie Humaine, CHU Amiens-Picardie, Avenue R. Laennec, 80054, Amiens Cedex1, France.
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Pushker N, Bajaj MS, Singh AK, Lokdarshi G, Bakhshi S, Kashyap S. Intra-ocular medulloepithelioma as a masquerade for PHPV and Panophthalmitis: a Diagnostic Dilemma. Saudi J Ophthalmol 2017; 31:109-111. [PMID: 28559724 PMCID: PMC5436372 DOI: 10.1016/j.sjopt.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 02/08/2017] [Indexed: 12/02/2022] Open
Abstract
A previously diagnosed child of persistent hyperplastic primary vitreous (PHPV) with painless blind eye remained clinically silent for about 3 years follow-up. The child suddenly presented as a case of orbital cellulitis and panopthalmitis with meningitis. No definite mass lesion was detected on ultrasonography, magnetic resonance imaging (MRI) and positron emission tomography (PET) scan. Histopathology of the enucleated eye revealed intra-ocular medulloepithelioma as the culprit of sterile panophthalmitis and orbital inflammation.
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Affiliation(s)
- Neelam Pushker
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Mandeep S Bajaj
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Ashutosh K Singh
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Gautam Lokdarshi
- Oculoplastic and Pediatric Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Sameer Bakhshi
- Paediatric Oncology, Dr. B.R.A. IRCH, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
| | - Seema Kashyap
- Department of Ocular Pathology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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Abstract
Panophthalmitis is one of rare manifestations of tuberculosis described in atypical situations such as children, immune compromised patients, or drug abuse. The present report describes the first case of tubercular panophthalmitis developing after trauma in an otherwise healthy adult patient. A 46-year-old female patient presented with corneal infiltrate and endophthalmitis that developed after an injury to right eye with wooden object. Corneal scrapings and vitreous tap were sterile. The patient did not improve with antibiotics and developed panophthalmitis. On evisceration of the painful blind eye, histopathology showed the presence of granulomatous inflammation and acid-fast bacilli. The patient had no other systemic focus of tubercular infection. The patient was managed with anti-tubercular therapy for 6 months. Atypical presentations of tuberculosis like panophthalmitis pose a difficult problem in diagnosis as well as treatment. Direct inoculation of bacilli during trauma is a rare source of infection. This case report presents unusual development of tubercular panophthalmitis following direct inoculation of bacilli during trauma. Ocular tuberculosis should be considered in differential diagnosis of posttraumatic endophthalmitis and panophthalmitis, especially in endemic regions like India.
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Affiliation(s)
- Pankaj Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ramandeep Singh
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Suruchi Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Abhiraj Kumar
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nandita Kakkar
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Kumar N, Garg N, Kumar N, Van Wagoner N. Bacillus cereus panophthalmitis associated with injection drug use. Int J Infect Dis 2014; 26:165-6. [PMID: 25016038 DOI: 10.1016/j.ijid.2014.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/18/2014] [Accepted: 01/20/2014] [Indexed: 11/25/2022] Open
Abstract
We report a case of rapidly progressive vision loss in a young woman with a history of injection drug use. Subsequent enucleation of the affected eye was done and Bacillus cereus grew on tissue culture. B. cereus is a rare cause of endogenous endophthalmitis due to hematogenous seeding of the vitreous in the setting of injection drug use.
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Affiliation(s)
- Nilay Kumar
- Department of Medicine, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge St, Cambridge, MA 02139, USA.
| | - Neetika Garg
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA
| | - Nilesh Kumar
- Department of Medicine, Manipal University, Manipal, Karnataka, India
| | - Nicholas Van Wagoner
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Abstract
Purpose: The aim of this study was to determine the types and nature of traditional eye medications (TEMs), their sources, and the ocular complications that may arise from use in a teaching hospital in Nigeria. Materials and Methods: A prospective study of consecutive subjects who used TEM before presentation to the Eye Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria between July 1, 2004 and June 30, 2008. P < 0.05 was considered statistically significant. Results: A total of 113 subjects were evaluated of which 64 were males (56.6%), females (43.4%) were females. There was no significant difference in the number of males and females (P > 0.05). Rural dwellers were more likely to use TEM than urban dwellers (P < 0.0001). The mean age of the subjects was 47.9 ± 22.3 years (range, 4-90 years). The most common traditional medication was derived from plant extracts (54.9%) followed by concoctions (21.2%). Complications occurred in 54.8% of the subjects. Ocular complications included corneal opacities in 13.35% of subjects, staphyloma in 9%, and corneal ulcers in 8%. Other complications were panophthalmitis, endophthalmitis, uveitis, cataract, and bullous keratopathy. Eleven subjects underwent evisceration or enucleation of the affected eye. There was no significant difference in the type of medication used and ocular complications (P = 0.956). Sources of TEM were self-medication in 38.9% of subjects, relatives in 27.4%, and traditional healers in 17.7%. Conclusion: The use of TEM is a common practice that could be harmful and lead to blindness. Proper health education of the public and traditional healers can reduce the prevalence of preventable blindness.
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Affiliation(s)
- Catherine U Ukponmwan
- Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Nigeria
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