Hämatogene Serratia marcescens Endophthalmitis bei einem HIV-infizierten I.-v.-Drogenabhängigen

Abstract

A case of haematogenous Serratia marcescens endophthalmitis in an HIV-infected intravenous drug addict is described. The patient was admitted with fever, ocular pain and visual loss in the right eye following an i.v. injection of pulverized buprenorphine. A vitreous humor culture grew S. marcescens. The patient was treated with i.v. ceftriaxone (2 g b. i. d.), i.v. amikacin (500 mg b. i. d.) and p. o. fosfomycin (1 g q. i. d.) for three weeks. The ocular infection was cured, although the visual function was lost, leading to blindness. To our knowledge, this is the second case in the reviewed Anglo Saxon literature of S. marcescens endophthalmitis in parenteral drug addicts.

The revival of fosfomycin

“…All studies dealing with the curative use of intravenous fosfomycin in adult patients are presented in Table 1. 33,65,66,[69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84]…”

“…The daily dose ranges from 12 to 16 g on average, administered in 2-4 infusions. Daily doses of up to 20 g Alvarez et al 71 1 -Serratia marcescens Endophthalmitis Ceftriaxone + amikacin 0 Boulard et al 72 4 -Staphylococcus epidermidis CSF shunt infection Aminoglycoside 0 Bureau-Chalot et al 73 1 -Stomatococcus mucilaginosus Spondylodiscitis Cefotaxime 0 Florent et al 70 72 55 Multiple Multiple Multiple 13 Gillard et al 74 8 --Pyogenic discitis Quinolone a 0 Guerin et al 75 1 46…”

Endogenous Serratia Marcescens Endophthalmitis

“…Of the patients with a history of intravenous drug use, one patient had a history of glomerulonephritis and mycotic aneurysms of the superior mesenteric artery with positive blood and urine cultures, 3 while the second had a concurrent diagnosis of HIV and history of Candida endophthalmitis in the fellow eye. 4 In contrast, our patient was found only to have severe dental disease without any medical problems, recent surgery, or recent antibiotic use and was HIV-negative.…”

“…6,7 Of the 12 reported cases of endogenous S. marcescens endophthalmitis in the English literature, 3 occurred in neonates with sepsis, 7 in adults with either systemic illness or recent nonocular surgery, and 2 cases in patients with intravenous drug use. [1][2][3][4] None of the previously reported cases had a reported history of dental disease. We report the first case of endogenous S. marcescens endophthalmitis in association with dental disease in an immunocompetent, intravenous heroin user.…”

“…After conducting a systematic literature search using PubMed with the terms "Serratia marcescens," "endogenous," and "endophthalmitis," we identified 12 reported cases of endogenous endophthalmitis secondary to S. marcescens in the English literature. [1][2][3][4] The majority of reported cases occur in patients with systemic illness, recent nonocular surgery, indwelling catheters, immunocompromised status, or very rarely patients with intravenous drug use. We report the first case of endogenous S. marcescens endophthalmitis associated with dental disease in an otherwise healthy, HIV-negative individual who admitted to intravenous heroin use.…”