Fulminant Endogenous Anterior Uveitis due to Listeria monocytogenes

Hueber, Arno; Welsandt, Gerhard; Grajewski, Rafael S.; Roters, Sigrid

doi:10.1159/000321127

Cited by 12 publications

(11 citation statements)

References 5 publications

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“…The median age of the patients was 62 (interquartile range (IQR) =18) years, with the youngest being 24 and the oldest at 88 years (Table 1 , 2 ). The present case, as well as nine of the twenty-six published cases of L. monocytogenes endophthalmitis, occurred in immunocompromised patients (37 %) [ 11 , 14 , 17 , 19 , 22 , 25 , 27 , 29 , 34 ]. Five cases (19 %) occurred in patients with chronic diseases such as neurodermitis, sacroiliitis, diabetes mellitus (present case), arterial hypertension, hypothyroidism, or previous history of cancer or surgery (coronary artery bypass graft) [ 16 , 21 , 24 , 26 , 30 ] (Table 2 ) .…”

Section: Review On Symptoms Clinic Treatment and Outcome Of Publishmentioning

confidence: 69%

“…In single cases, the infection led to enucleation, blindness, or strong visual loss [ 19 , 30 , 31 , 33 ]. In eight cases (30 %), a cataract developed, which led to decreased VA with subsequent cataract surgery [ 16 , 18 , 22 , 24 , 25 , 27 – 29 ]. Further ocular surgical operations were needed in five other cases (19 %); two patients needed a keratoplasty, and two other patients needed a trebeculectomy (7 % each) to manage the secondary glaucoma [ 13 , 21 , 22 ].…”

Section: Review On Symptoms Clinic Treatment and Outcome Of Publishmentioning

confidence: 99%

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Listeria monocytogenes endophthalmitis – case report and review of risk factors and treatment outcomes

et al. 2016

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BackgroundThe majority of cases of endophthalmitis are caused by exogenous pathogens; only 5–10 % are of endogenous origin. One cause of these rare cases of endogenous endophthalmitis is Listeria monocytogenes. Twenty-six cases of endophthalmitis due to this pathogen have been published over the last twenty years. The aim of this review is to summarize the main risk factors and common clinical findings of endogenous endophthalmitis due to Listeria monocytogenes.Case presentationWe report on a 62-year-old female presenting with a sterile hypopyon iritis with secondary glaucoma and an underlying rheumatoid disease. In microbiological analysis we identified Listeria monocytogenes. Further we searched through all published cases for typical signs, risk factors, details of medical and surgical treatment and outcome of endogenous endophthalmitis due to this rare pathogen.Ocular symptoms in almost all of these published cases included pain, redness of the eye, and decreased vision. Main clinical features included elevated intraocular pressure and fibrinous anterior chamber reaction, as well as a dark hypopyon. While the infection is typically spread endogenously, neither an exogenous nor endogenous source of infection could be identified in most cases. Immunocompromised patients are at higher risk of being infected than immunocompetent patients. The clinical course of endophthalmitis caused by Listeria monocytogenes had different visual outcomes. In some cases, the infection led to enucleation, blindness, or strong visual loss, whereas most patients showed a tendency of visual improvement during therapy.ConclusionEarly diagnosis and treatment initiation are crucial factors in the outcome of endogenous endophthalmitis caused by Listeria monocytogenes. This possible differential diagnosis should be kept in mind while treating patients with presumable sterile hypopyon and anterior uveitis having a high intraocular pressure. A bacterial source should be considered with a prompt initiation of systemic antibiotic treatment, mainly in immunocompromised patients, who develop endogenous anterior uveitis. An appropriate microbiological sampling is essential to detect atypical microorganisms and to choose an effective antibiotic treatment.

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Section: Review On Symptoms Clinic Treatment and Outcome Of Publishmentioning

confidence: 69%

Section: Review On Symptoms Clinic Treatment and Outcome Of Publishmentioning

confidence: 99%

Listeria monocytogenes endophthalmitis – case report and review of risk factors and treatment outcomes

et al. 2016

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“…Many cases develop an evolving dark hypopyon due to iris pigment dispersion [ 8 ]. Most reports have final vision worse than 20/200, and only two reports document final visual acuity better than 20/60 [ 6 , 9 , 10 ]. We present a case of endogenous L. monocytogenes endophthalmitis in a healthy male who recovered 20/20 vision after aggressive intravitreal and systemic antibiotic therapy and anterior chamber washout.…”

Section: Resultsmentioning

confidence: 99%

A case of Listeria monocytogenes endophthalmitis with recurrent inflammation and novel management

Weber

Levison

Srivastava

et al. 2015

J Ophthal Inflamm Infect

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BackgroundListeria monocytogenes is a rare cause of endogenous endophthalmitis. In the limited number of reported Listeria endophthalmitis cases, visual acuity outcomes have been very poor.FindingsHere, we report a case of Listeria endophthalmitis that was complicated by recurrent inflammation. The patient required treatment with both intravitreal and long-term systemic antibiotics. An anterior chamber washout was necessary for the patient to regain 20/20 visual acuity.ConclusionsThis case highlights the importance of considering Listeria early in the disease course, as it has low sensitivity to standard empiric antibiotic therapy. It also stresses the importance of addressing damaging inflammation in infectious conditions.

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“…In such conditions ultrasound biomicroscopy might be helpful8 using PCR for identification of such a pathogen (Listeria) in intraocular infections has been recommended 17. This might ensure prompt appropriate antimicrobial therapy specially in patients with comorbidities 918…”

Section: Discussionmentioning

confidence: 99%

Pigmented hypopyon in association with Listeria monocytogenes endopthalmitis: An interesting case report following refractive surgery procedure with literature review

Alkatan

Al-Dhibi

Edward

et al. 2014

Middle East Afr J Ophthalmol

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Purpose:Listeria monocytogenes is an aerobic, motile, gram positive bacillus recognized as an intercellular pathogen in human where it most frequently affects neonates, pregnant women, elderly patients, and immunosuppressed individuals as well as healthy persons. Ocular listeriosis is rare, most frequently in the form of conjunctivitis, but has been also shown to cause rarely endophthalmitis with pigmented hypopyon and elevated intraocular pressure such as in our case.Materials and Methods:We are reporting one immunocompetent patient presenting with dark hypopyon following laser refractive procedure. His clinical findings, investigations, and further management are all described with relevant literature review of similar cases.Results:Diagnosis of ocular listeriosis was confirmed by positive culture of anterior chamber (AC) aspirate with identification of the above organism. His visual outcome was satisfactory with good preserved vision.Conclusion:We believe that his ocular infection was exogenous and that ophthalmologists should be aware of the causative organisms of colored hypopyon to avoid delayed diagnosis.

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Fulminant Endogenous Anterior Uveitis due to Listeria monocytogenes

Cited by 12 publications

References 5 publications

Listeria monocytogenes endophthalmitis – case report and review of risk factors and treatment outcomes

Listeria monocytogenes endophthalmitis – case report and review of risk factors and treatment outcomes

A case of Listeria monocytogenes endophthalmitis with recurrent inflammation and novel management

Pigmented hypopyon in association with Listeria monocytogenes endopthalmitis: An interesting case report following refractive surgery procedure with literature review

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