Endogenous Endophthalmitis Associated with Indwelling Medical Devices

Ciociola, Elizabeth C.; Powell, Jeffrey C.; Zehden, Jason; Robbins, Cason B.; Zhang, Alice Yang; Fekrat, Sharon; Greven, Margaret A.

doi:10.1016/j.oret.2022.10.013

Cited by 1 publication

(2 citation statements)

References 6 publications

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“…Our findings further corroborate the notion that IDU causes a transient fungemia which is less likely to affect both eyes. 5,21 Other cases of endogenous endophthalmitis such as those due to indwelling medical device infection 22 or those which occur in patients with sustained systemic infections have reported much higher rates of bilateral disease. 18,23,24 In our study, most of the IDU patients (71%) did not have an identifiable systemic source of infection, whereas most of the patients with non-IDU-associated endogenous endophthalmitis did.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endogenous Endophthalmitis Associated with Injection Drug Use Compared with Other Etiologies

Ciociola

Powell

Barnwell

et al. 2023

Retina

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Purpose: To compare features of endogenous endophthalmitis associated with injection drug use (IDU) to endogenous endophthalmitis from other etiologies. Methods: We retrospectively collected data on patients with endogenous endophthalmitis due to IDU or other causes from three academic tertiary care centers over a six-year period. Differences in presenting characteristics, culture results, treatment, and visual acuity (VA) were compared between groups. Results: Thirty-eight (34%) patients had IDU-associated endogenous endophthalmitis, while 75 (67%) had endogenous endophthalmitis from other causes. Compared to patients in the non-IDU group, IDU patients were significantly younger, more frequently male, had longer duration of symptoms at diagnosis, and were less likely to have bilateral disease (p<0.05 for all). IDU patients were less likely to have a systemic infection source identified (29% vs 71%, p<0.001) or have positive cultures (47% vs 80%, p<0.001). The IDU group was less likely to be admitted to the hospital (71% vs 92%, p=0.005) and less likely to receive treatment with intravenous antimicrobials (55% vs 83%, p=0.003). VA did not significantly differ between groups. Conclusions: Endophthalmitis related to IDU presents in younger patients with less comorbidities and frequently without positive cultures or an identifiable systemic source; therefore, a high index of suspicion is needed to identify this disease.

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