“…Anterior chamber inflammation with hypopyon, absent red reflex, vitreous cells, and haze may also occur [ 21 , 28 ]. These findings of anterior chamber involvement are more common in bacterial causes of EE [ 6 ]. There may be a poor view of the fundus due to the presence of exudates and vitreous haze.…”
Section: Reviewmentioning
confidence: 99%
“…Methicillin-resistant Staphylococcus aureus (MRSA) associated endophthalmitis is associated with high rates of retinal detachment especially when the time period between onset of symptoms and presentation is delayed by more than 2 weeks [ 3 ]. Other non-specific findings can include flame-shaped hemorrhages, Roth spots and cotton wool spots [ 6 , 45 ]. Fig.…”
Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.
“…Anterior chamber inflammation with hypopyon, absent red reflex, vitreous cells, and haze may also occur [ 21 , 28 ]. These findings of anterior chamber involvement are more common in bacterial causes of EE [ 6 ]. There may be a poor view of the fundus due to the presence of exudates and vitreous haze.…”
Section: Reviewmentioning
confidence: 99%
“…Methicillin-resistant Staphylococcus aureus (MRSA) associated endophthalmitis is associated with high rates of retinal detachment especially when the time period between onset of symptoms and presentation is delayed by more than 2 weeks [ 3 ]. Other non-specific findings can include flame-shaped hemorrhages, Roth spots and cotton wool spots [ 6 , 45 ]. Fig.…”
Endogenous endophthalmitis is an ophthalmic emergency that can have severe sight-threatening complications. It is often a diagnostic challenge because it can manifest at any age and is associated with a number of underlying predisposing factors. Microorganisms associated with this condition vary along a broad spectrum. Depending upon the severity of the disease, both medical and surgical interventions may be employed. Due to rarity of the disease, there are no guidelines in literature for optimal management of these patients. In this review, treatment guidelines based on clinical data and microorganism profile have been proposed.
“…Ischemic optic neuropathy is a rare but serious complication of critical illness [1][2][3] that has an anterior and a posterior type, each of which has several subtypes. 4 Anterior ischemic optic neuropathy has 2 types: arteritic (due to giant cell arteritis) and nonarteritic (due to other causes and much more common).…”
M ost patients discharged from critical care, particularly after septic shock, experience problems with physical, psychosocial, and emotional functioning. We report on bilateral blindness and unilateral sensorineural hearing loss as rare but severely disabling complications in a young survivor of septic shock.
Case ReportA 42-year-old man with a history of psoriatic arthritis, for which he used methotrexate (2.5 mg once a week), came to the emergency department with abdominal pain 2 days after endoscopic repair of an inguinal hernia on the left side. Laboratory examination revealed an elevated level of C-reactive protein (51 mg/L, reference value < 10 mg/L; to convert to nanomoles per liter, multiply by 9.524) and leukocytosis (13.9 x 10 9 /L; reference value, 4.0-10.0 x 10 9 /L), with an elevated level of neutrophils (12.6 x 10 9 /L; reference value, 1.3-5.7 x 10 9 /L) among others. Ultrasound showed a fluid collection in the abdominal wall, thought to indicate a rectus hematoma.The patient was admitted to the surgical care area for observation and analgesia, but clinical deterioration occurred and septic shock developed within 12 hours of admission. The patient was admitted to the intensive care unit (ICU) and resuscitated with fluids and vasopressors. Antibiotics (ceftriaxone and metronidazole) were administered to treat Abstract A young man had severe septic shock with multiorgan failure due to necrotizing fasciitis caused by group A streptococcus after endoscopic repair of a preperitoneal inguinal hernia. He was treated with surgical exploration and antibiotics and resuscitated with fluids, vasopressors, and inotropic agents. He survived this critical illness, but when he woke up from sedation, his vision was lost in both eyes. Ophthalmological evaluation revealed minimal peripapillary retinal hemorrhages without signs of papillary edema. Visually evoked potentials were negative. Magnetic resonance imaging did not show a cause of the visual damage. The patient had bilateral ischemic optic neuropathy diagnosed. Two weeks later, unilateral sudden deafness also developed. The acquired blindness and hearing loss were unchanged after more than 1 year and seem to be permanent, severely disabling this young survivor of septic shock. (American Journal of Critical Care. 2015;24:450-452) Cases of Note Cases of Note features peer-reviewed case reports and case series that document clinically relevant findings from critical and high acuity care environments. Cases that illuminate a clinical diagnosis or a management issue in the treatment of critically and acutely ill patients and include discussion of the patient's experience with the illness or intervention are encouraged. Proposals for future Cases of Note articles may be e-mailed to ajcc@aacn.org. a suspected abdominal infection and an emergency laparotomy was performed, which showed turbid fluid but no perforation or abscess. The mesh was removed and culture samples were taken. When cultures revealed hemolytic group A streptococcus, antibiotic treatment was swi...
“…B. eine initiale Fehldiagnose (z. B. als sterile Uveitis, Glaukom oder Sinus-cavernosus-Thrombose [20,25,26]) konnten wir in der untersuchten Kohorte nicht nachweisen. Eine endogene Endophthalmitis breitet sich durch die Keimeinschleppung über die A. ophthalmica von posterior nach anterior aus, sodass die für Nichtophthalmologen sichtbaren vorderen Augenabschnitte erst bei fortgeschrittener Ausdehnung der Entzündung erkennbar betroffen werden und ein Augenarzt hinzugezogen wird.…”
Endogenous endophthalmitis is often misdiagnosed due to a severe underlying non-ophthalmological disease. Delayed presentation with consequent late initiation of therapy is an unresolved problem, because colleagues from other fields are often unexperienced in diagnosing the ocular infection. This is also a cause of the already poor visual prognosis. Ophthalmologists can usually only influence the choice of the proper therapy.
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