Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual prognosis and outcomes

Zapp, Daniel; Loos, D; Feucht, Nikolaus; Khoramnia, Ramin; Tandogan, Tamer; Reznicek, Lukas; Mayer, Christian

doi:10.1186/s12886-018-0777-3

Cited by 28 publications

(38 citation statements)

References 24 publications

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“…Studies have documented progression of infectious keratitis to endophthalmitis in 0.3% to 6.1% of cases. 40,41 Endophthalmitis secondary to keratitis or corneal ulcers is associated with particularly poor outcomes and a high rate of enucleation. [42][43][44] Similarly, the presence of an RD in our study was also associated with PTE; the reason for this may be that RD implies that the severity of the trauma was great enough to involve the posterior segment.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Uppuluri

Zarbin

Bhagat

2020

Journal of VitreoRetinal Diseases

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Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Uppuluri

Zarbin

Bhagat

2020

Journal of VitreoRetinal Diseases

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“…Inconsistencies in routine smear tests for initially mild cases of keratitis which later turn into endophthalmitis may further obscure the accurate estimation of microbial association and detection rates. [5] We present herein three clinical cases to illustrate this.…”

Section: Introductionmentioning

confidence: 94%

Cervicofacial infections caused by Staphylococcus aureus

Lazarte

Paladino

Mollo

et al. 2019

Ann Maxillofac Surg

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Staphylococcus aureus (S. aureus) is an opportunistic pathogen that causes a wide range of diseases. Dissemination of perioral infections is a common problem in the field of oral and maxillofacial surgery. The aim of the study was to evaluate S. aureus carriage in the oral cavity and its dissemination to different cervicofacial regions. Clinical case 1 is a patient with a systemic history of type I diabetes which led to foot amputation one year previou sly, who presented alteration of ocular motility and the culture showed Grampositive cocci compatible with S. aureus. The patient was discharged after eight days of antibiotic therapy and drainage. Clinical case 2 was a young female without any comorbidities who had never been hospitalized before or even exposed to the hospital environment. The presence of lesions compatible with necrotizing fasciitis (NF) in the lower lip mucosal region, rapid evolution of the infection to deep planes, and evolution of the clinical picture alerted health-care providers to the need for prompt care. Clinical case 3 was an immunosuppressed patient with cellulitis which is a bacterial infection of the skin and soft tissues that occurs when the physical barrier of the skin and soft tissues, the immune system, and/or the circulatory system are affected. S. aureus is an opportunistic pathogen which causes a wide range of diseases. It inhabits the oral cavity, from where it can spread to distant cervicofacial regions. This is why it is important for health-care professionals to be aware of this niche in case of dissemination in order to provide prompt diagnosis and appropriate treatment.

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“…Common symptoms of CU are massive pain, blepharospasm, photophobia, and tearing (Herz et al, 2008). If diagnose delayed, CU can result in severe complications including corneal perforation, endophthalmitis, and iris atrophy (Herz et al, 2008; Rana et al, 2015; Zapp et al, 2018). The tentative diagnosis of CU can often be made by slit lamp, fluorescein staining and in vivo confocal microscopy (IVCM) (Herz et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Altered Regional Homogeneity in Patients With Corneal Ulcer: A Resting-State Functional MRI Study

Liu

Tan

et al. 2019

Front. Neurosci.

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Objective To investigate the potential regional homogeneity (ReHo) brain activity changes in patients with corneal ulcer (CU) and their possible relationship with clinical symptoms. Materials and Methods Forty patients with CU (26 men and 14 women), and 40 healthy controls (HCs) (26 men and 14 women) closely matched in age, sex, and weight underwent resting-state functional MRI scans, respectively. The ReHo method was applied to evaluate synchronous neural activity changes. Receiver operating characteristic curve (ROC curve) was used to show high test-retest stability and high degree of sensitivity and specificity. We utilized the correlation analysis to calculate the relationship between the average ReHo signal values in different brain areas and the clinical symptoms in CU patients. Results Compared with the HCs, CU patients had significantly increased ReHo values in right cerebellum posterior lobe, left cerebellum posterior lobe, left inferior temporal gyrus, right lingual gyrus, left middle frontal gyrus, left angular gyrus, left cingulate gyrus, right angular gyrus and bilateral superior frontal gyrus, and decreased ReHo values in right anterior cingulate and left precentral gyrus. ROC curve analysis of each brain regions showed the accuracy of AUC was perfect except the right cerebellum posterior lobe. Nevertheless, there was no clear evidence of prominent relevance between the average ReHo values in brain areas and the clinical symptoms. Conclusion Corneal ulcer caused dysfunctional adaption in different brain areas, which including relatively increased values and decreased values. This finding may help us take a further step in exploring the underlying pathologic mechanisms of CU.

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Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual prognosis and outcomes

Cited by 28 publications

References 24 publications

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Risk Factors for Post–Open-Globe Injury Endophthalmitis

Cervicofacial infections caused by Staphylococcus aureus

Altered Regional Homogeneity in Patients With Corneal Ulcer: A Resting-State Functional MRI Study

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