Citrobacter diversus Endophthalmitis Following Penetrating Keratoplasty

Insler, Michael S.; Kook, Michael S.; Mani, Hamid; Peyman, Gholam A.

doi:10.1016/0002-9394(88)90604-6

Cited by 10 publications

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“…13 In a large series of patients with endophthalmitis caused by gram-negative organisms, 4 postoperative patients had endophthalmitis caused by C. koseri, and 1 of 4 achieved visual acuity 20/400 or better. 17 Essex et al reported a case of posttraumatic endophthalmitis caused by Bacillus cereus and Citrobacter freundii, and evisceration was finally performed in this patient.…”

Section: Discussionmentioning

confidence: 99%

Endophthalmitis Caused byCitrobacterSpecies

Chen

Sun

Hwang

et al. 2008

Ocular Immunology and Inflammation

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Section: Discussionmentioning

confidence: 99%

Endophthalmitis Caused byCitrobacterSpecies

Chen

Sun

Hwang

et al. 2008

Ocular Immunology and Inflammation

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“…Previously published studies concerning endophthalmitis caused by Citrobacter species are limited to case reports. 2 We report a case of diffuse retinal vasculitis in C. koseri posttraumatic endophthalmitis with IOFB. Patients should be made aware of the need to seek surgical management after ocular penetrating injury with IOFB.…”

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confidence: 90%

Diffuse Retinal Vasculitis in Citrobacter koseri Traumatic Endophthalmitis With Intraocular Foreign Body

Chen

2010

Journal of Trauma: Injury, Infection &Amp; Critical Care

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A 43-year-old man suffered from corneal perforation by a metal fragment in the right eye while using a lawn mower. At presentation, his visual acuity was hand motion in the right eye and 20/20 in the left eye. Anterior segment demonstrated a 3.5-mm full-thickness corneal laceration, fibrin over pupillary margin, and traumatic cataract. Computed tomography demonstrated a high density of metallic fragment in the vitreous cavity. Traumatic endophthalmitis with intraocular foreign body (IOFB) was diagnosed, and emergent operation was immediately performed after 12 hours of ocular injury. Diffuse retinal vasculitis, vitreous opacity, and an intraocular metal fragment were found during vitrectomy ( Fig. 1). At the end of surgery, intravitreal injections of vancomycin (1 mg/0.1 mL) and amikacin (0.2 mg/0.1 mL) were performed. Cultures of vitreous fluid revealed gramnegative bacilli identified as Citrobacter koseri, which was sensitive to amikacin and ceftazidime. Because of persistent vitreous inflammation, intravitreal injections of amikacin and dexamethasone were performed on day 4. Three months later, the best-corrected visual acuity was 20/60. Fundus examination showed the resolution of retinal vasculitis (Fig. 2).Infectious endophthalmitis is an uncommon but serious ocular infection often resulting in severe vision loss. Retinal vasculitis is one of the most common signs of endophthalmitis; however, it has been rarely reported in the literature. 1 Citrobacter species are gram-negative nonspore-forming rods and are isolated from water, soil, food, and the intestinal tracts of humans and animals. Previously published studies concerning endophthalmitis caused by Citrobacter species are limited to case reports. 2 We report a case of diffuse retinal vasculitis in C. koseri posttraumatic endophthalmitis with IOFB. Patients should be made aware of the need to seek surgical management after ocular penetrating injury with IOFB. Prompt management may save the eye and achieve a favorable visual outcome. REFERENCES1. Packer AJ, Weingeist TA, Abrams GW. Retinal periphlebitis as an early sign of bacterial endophthalmitis. Am J Ophthalmol. 1983;96:66 -71. 2. Insler MS, Kook MS, Mani H, Peyman GA. Citrobacter diversus endophthalmitis following penetrating keratoplasty. Am J Ophthalmol.Figure 1. Diffuse retinal vascular sheathening (vasculitis), retinal hemorrhage, and peripapillary hemorrhage were showed in the posterior fundus.Figure 2. Fundus photograph showed the resolution of retinal vasculitis.

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