Clostridial Endophthalmitis: Clinical Presentations, Management Outcomes, and Review of Literature

Endophthalmitis is a rare and infectious disease caused by Streptococcus suis (S suis). Traditionally, S suis is detected by the pathogenic microorganism culture method, which has low positivity and high false negativity. Nanopore sequencing (NS), which is a third-generation sequencing technology, has several advantages over the traditional method; in particular, it is cost and time effective and has a high throughput. In this report, a case of infectious endophthalmitis caused by trauma is examined. The NS results suggest that the pathogen in question is a mixed infection caused by S suis and Clostridium perfringens. This case report provides evidence of the fact that NS can quickly identify pathogens, which is of great significance for clinical diagnosis and treatment.

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“…Early administration of vitrectomy can save patient vision (to a certain extent) and preserve the eyeball. 13…”

Section: Discussionmentioning

confidence: 99%

Detecting Streptococcus suis by nanopore sequencing in endophthalmitis: A case report

2021

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“…Clostridial ocular infections have been well documented in humans 6 in association with perforating eye injury resulting in panophthalmitis 7 . However, none of the human case reports nor studies in animals have reported the isolation of C. chauvoei from ocular lesions.…”

Section: Introductionmentioning

confidence: 99%

Clostridial panophthalmitis – An unusual case of localised malignant oedema in Merino lambs associated withClostridium chauvoei

Moloney

Evers²

2022

Aust Veterinary J

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The authors report an unusual case of Clostridium chauvoei causing severe panophthalmitis in Merino lambs. More than half of the lambs affected survived, which is unusual for clostridial disease; however, there have been reports in humans that the mortality risk for ocular gas gangrene is lower than when other body parts are affected. A combination of factors in this case included environmental contamination (specific to a particular paddock), genetics predisposing to entropion (lambs born of maiden 2‐year‐old ewes with some inbreeding), the practice of manually everting eyelids for the entropion and vaccination strategies. C. chauvoei was cultured in pure growth from the eye of a lamb affected by severe panophthalmitis. Histopathology was consistent with severe acute infection, and microscopic sections showed Gram‐positive organisms associated with the inflammatory response in the eye. In the acutely affected animal examined there were no signs that the lesions were long‐standing. Animals that recovered had one or both eyes destroyed. This report describes that malignant oedema in sheep due to C. chauvoei can manifest as acute and severe panophthalmitis. The case fatality rate of lambs with panophthalmitis was less than 50%, lower than normally occurs for clostridial diseases. Clostridial vaccination of the ewes may have provided a low level of protection in reducing the case fatality rate in the affected lambs as well localisation of the infection from the blood–ocular barrier.

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<p>Can Prompt Endoscopic Vitrectomy in Post-Trauma Endophthalmitis with Corneal Edema Avoid Unnecessary Keratoplasties?</p>

Khader¹,

Pappuru²,

Dave³

2020

IMCRJ

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Objective To describe a series of prompt endoscopic vitrectomy in eyes with post-trauma endophthalmitis and hazy cornea. Methods Retrospective consecutive interventional case series. Cases of endophthalmitis with hazy cornea which underwent prompt endoscopic vitrectomy were analyzed. The study period was from August 2018 to April 2019. The final anatomic and functional outcomes are reported here. Results Four eyes of four patients were included. Mean age at presentation was 24.50±21.29 years (median 24 years). All cases were post-open globe injury. Microbiology showed smear positivity in 3/4 (75%) and culture positivity in 2/4 (50%). The antibiotic susceptibility was 100% for vancomycin and ceftazidime. Mean follow-up was 7.75±1.7 months (median 7.5 months). Favorable anatomic outcome was seen in 100% of cases and favorable functional outcome in 75% cases. Conclusion Endoscopic vitrectomy allows for early intervention in endophthalmitis post open-globe injuries. This enables early resolution of infection and avoids a need for unnecessary corneal interventions.

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Clostridial Endophthalmitis: Clinical Presentations, Management Outcomes, and Review of Literature

Cited by 4 publications

References 18 publications

Detecting Streptococcus suis by nanopore sequencing in endophthalmitis: A case report

Detecting Streptococcus suis by nanopore sequencing in endophthalmitis: A case report

Clostridial panophthalmitis – An unusual case of localised malignant oedema in Merino lambs associated withClostridium chauvoei

<p>Can Prompt Endoscopic Vitrectomy in Post-Trauma Endophthalmitis with Corneal Edema Avoid Unnecessary Keratoplasties?</p>

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