Recurrent Enterococcus faecalis endophthalmitis after phacoemulsification.

Published on Mar 1, 2005in Journal of Cataract and Refractive Surgery2.689
· DOI :10.1016/J.JCRS.2004.06.047
Stephen C. Teoh18
Estimated H-index: 18
(TTSH: Tan Tock Seng Hospital),
Jong-Jian Lee2
Estimated H-index: 2
+ 1 AuthorsKah-Guan Au Eong20
Estimated H-index: 20
We present the first reported case of late recurrence of postoperative Enterococcus faecalis endophthalmitis after cataract surgery in a 45-year-old diabetic man. Culture-positive E faecalis endophthalmitis was diagnosed 2 days after uneventful phacoemulsification. Early vitrectomy with intravitreal and subconjunctival vancomycin and amikacin and topical vancomycin resulted in apparently complete clinical resolution after 4 months and a best corrected visual acuity of 20/25. Recurrent endophthalmitis with hypopyon occurred 7 months postoperatively and resolved with intravitreal vancomycin and topical prednisolone acetate 1%. However, the patient had a similar relapse at 9 months that resulted in deterioration of visual acuity to no light perception despite a repeat vitrectomy, intraocular lens explantation, capsular bag removal, and intravitreal antibiotics. The late recurrences could have been the result of persistent sequestration of the organism in the capsular bag.
📖 Papers frequently viewed together
64 Citations
17 Citations
1 Citations
A case of Enterococcal endophthalmitis developed following an extracapsular cataract extraction. The infection was successfully treated with intravenous and intravitreal ampicillin, but a secondary glaucoma led to a later enucleation. We report a case of postoperative endophthalmitis with an unusual etiology, which did not respond to common treatment.
7 CitationsSource
#1Ingrid U. Scott (UM: University of Miami)H-Index: 96
#2Roy H. Loo (UM: University of Miami)H-Index: 3
Last. Darlene Miller (UM: University of Miami)H-Index: 61
view all 4 authors...
Abstract Purpose To investigate clinical settings, treatment strategies, and visual acuity outcomes of endophthalmitis caused by Enterococcus faecalis and to determine antibiotic sensitivity and resistance patterns. Design Retrospective, noncomparative, consecutive case series. Participants and methods Records were reviewed of all patients with culture-positive endophthalmitis caused by E. faecalis evaluated at the Bascom Palmer Eye Institute between January 1, 1990, and December 31, 2001. Main ...
64 CitationsSource
Abstract Purpose To determine the in vitro bacterial adherence to intraocular lenses (IOLs) routinely used at 1 center. Setting University Hospital of Vienna, Vienna, Austria. Methods Four types of rigid IOLs (hydrophobic poly[methyl methacrylate] [PMMA] and hydrophilic heparin-surface-modified PMMA) and 5 types of foldable intraocular lenses (hydrophobic silicone, hydrophobic acrylic, and hydrophilic acrylic) were used in the experiment. Under standardized conditions, the IOLs were contaminated...
34 CitationsSource
#1Ellen N Yu (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 5
#2C. Stephen Foster (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 104
Abstract PURPOSE: To report a case of chronic postoperative endophthalmitis caused by the gram-negative bacterium Pseudomonas oryzihabitans . DESIGN: Interventional case report. METHODS: A 77-year-old man was referred to our service for nonpainful uveitis in the right eye accompanied by increased intraocular pressure of 2 years' duration with onset 4 months after uncomplicated extracapsular cataract extraction and posterior chamber intraocular lens implantation. The uveitis partially responded t...
14 CitationsSource
#1David C. Ritterband (New York Eye and Ear Infirmary)H-Index: 26
#2Mahendra ShahH-Index: 18
Last. John A. SeedorH-Index: 24
view all 5 authors...
Purpose. To report a case of Burkholderia gladioli keratitis with consecutive endophthalmitis. Methods. Case report and literature review. Results. A 76-year-old man with a history of diabetes mellitus developed bacterialkeratitis and consecutive endophthalmitis in the corneal graft of the left eye. Corneal, aqueous, and vitreous cultures yielded Burkholderia gladioli. Emergent keratoplasty, pars plana vitrectomy, and injection of intravitreal antibiotics led to resolution of the infection and i...
13 CitationsSource
Background: Postoperative endophthalmitis can be subdivided into acute and chronic forms which are typically caused by different organisms. Enterococcus faecalis is an organism which normally causes an acute form of endophthalmitis. Patients and methods: We report on four cases of different forms of endophthalmitis following cataract extraction and intraocular lens (IOL) implantation who had been referred to our institution between 1998 and 2001. Enterococcusfaecalis was the causative organism i...
4 CitationsSource
#1Jeffrey H. Stern (Albany Medical College)H-Index: 20
#2Christopher J. Calvano (Albany Medical College)H-Index: 7
Last. John W. Simon (Albany Medical College)H-Index: 26
view all 3 authors...
Abstract Endogenous Candida endophthalmitis resulting from candidemia in low-birth-weight infants usually occurs as a retinochoroiditis, which is effectively treated with systemic antifungal agents. We report a case of Candida endophthalmitis that recurred 4 months after completion of systemic antifungal therapy. The recurrent Candida infection affected primarily the iris and lens, rather than the retina and choroid. Vitrectomy was required for diagnosis and treatment. (J AAPOS 2001;5:50-1.)
25 CitationsSource
#1Naoichi Horio (Nagoya University)H-Index: 8
#2Hiroko Terasaka (Nagoya University)H-Index: 1
Last. Yozo Miyake (Nagoya University)H-Index: 56
view all 5 authors...
Abstract Purpose: To report the results of vitrectomy and intraocular lens (IOL) removal for the treatment of endophthalmitis after IOL implantation. Methods: We reviewed 14 eyes of 14 patients who underwent pars plana vitrectomy because of postoperative endophthalmitis. Culture results, surgical methods, and visual outcome are presented. Results: The cultures grew Enterococcus faecalis (n = 3), Staphylococcus epidermidis (n = 2), Propionibacterium acnes (n = 1), and gram-negative bacillus (n = ...
7 CitationsSource
#1John C. Chen (McGill University)H-Index: 14
#2Mili Roy (McGill University)H-Index: 2
Abstract Objective To report the clinical outcome of chronic Bacillus endophthalmitis after cataract surgery. Design Retrospective, noncomparative case series. Participants Five eyes of five patients with late-onset or recurrent inflammation after exposure to bacteria-contaminated viscoelastic material were studied. Intervention Repeated vitrectomies, wide excision of the remnant posterior capsule, and intravitreal injections of antibiotics in five patients. Eventual explantation of the intraocu...
15 CitationsSource
#1Anthony J Aldave (Thomas Jefferson University)H-Index: 5
#2Joshua D. Stein (Thomas Jefferson University)H-Index: 49
Last. Joseph I. Maguire (Thomas Jefferson University)H-Index: 23
view all 6 authors...
Abstract Purpose Propionibacterium acnes endophthalmitis after cataract extraction and posterior chamber intraocular lens (IOL) implantation is characterized by a chronic indolent course, frequently associated with recurrence after standard endophthalmitis treatment. This study was designed to evaluate the efficacy of various therapeutic methods in the treatment of primary and recurrent episodes of postoperative P. acnes endophthalmitis. Design Retrospective, noncomparative case series. Particip...
87 CitationsSource
Cited By18
#1Seung Min Lee (PNU: Pusan National University)H-Index: 10
#2Jong Ho ParkH-Index: 1
Last. Ik Soo Byon (PNU: Pusan National University)H-Index: 13
view all 4 authors...
Abstract The aim of this study was to investigate the efficacy of intravitreal povidone-iodine (PI) in the treatment of vancomycin-resistant Enterococcus faecalis (VRE) endophthalmitis. Fifty New Zealand white rabbits were divided into 5 groups (n = 10 in each group). After the induction of endophthalmitis using VRE (minimum inhibitory concentration [MIC] ≥ 40 μg/mL) in the right eye, Group A, B, C, and D received intravitreal injections of 0.1% PI, 0.3% PI, 0.05% vancomycin, and 0.5% vancomycin...
#1Vivek Pravin Dave (LVPEI: L V Prasad Eye Institute)H-Index: 6
#1Vivek DaveH-Index: 16
Last. Rajeev R PappuruH-Index: 16
view all 5 authors...
PURPOSE: To report the diagnosis and management of a series of chronic postoperative endophthalmitis caused by Stephanoascus ciferrii. METHODS: This is a retrospective consecutive case series at a tertiary eye care institute. Case records of consecutive cases of chronic postoperative endophthalmitis caused by a novel fungus S. ciferrii were analyzed. The clinical presentations, microbiologic workup including microscopy, culture, antifungal susceptibility and polymerase chain reaction for fungal ...
2 CitationsSource
#1Ryan A Shields (Beaumont Hospital)H-Index: 4
#2Ivan J. Lee (WVU: West Virginia University)
Last. Tarek S. Hassan (Oakland University)H-Index: 23
view all 7 authors...
Abstract Purpose Infectious endophthalmitis is a devastating, yet rare complication following intraocular surgery, trauma, and systemic illness. Given its rare incidence, few patients would be expected to have more than one episode of infectious endophthalmitis in their lifetime. We reviewed our patients who were diagnosed with, and treated for, at least two separate episodes of endophthalmitis. Design A retrospective, consecutive case series was conducted of patients managed at Associated Retin...
#1Christopher M. Aderman (Wills Eye Institute)H-Index: 5
#2Daniel L. Chao (USD: University of San Diego)H-Index: 16
Last. Cynthia S. Chiu (UCSF: University of California, San Francisco)H-Index: 7
view all 6 authors...
PURPOSE: To describe the first case report of a bilateral recurrent Enterococcus faecalis endophthalmitis postcataract surgery. METHODS: Case report with a description of the timeline, diagnosis, and management of a patient with bilateral recurrent E. faecalis endophthalmitis. RESULTS: An 89-year-old man presented 6 weeks' postcataract surgery with pain, tearing, and blurred vision in the left eye. B-scan ultrasonography revealed vitritis and cultures postvitrectomy grew E. faecalis. There was g...
1 CitationsSource
#1Gayatri Shankar Chilambi (University of Pittsburgh)H-Index: 1
#2Hayley R. Nordstrom (University of Pittsburgh)H-Index: 2
Last. Daria Van Tyne (University of Pittsburgh)H-Index: 20
view all 8 authors...
Enterococcus faecalis are hospital-associated opportunistic pathogens and also causative agents of post-operative endophthalmitis. Patients with enterococcal endophthalmitis often have poor visual outcomes, despite appropriate antibiotic therapy. Here we investigated the genomic and phenotypic characteristics of E. faecalis isolates collected from 13 patients treated at the University of Pittsburgh Medical Center Eye Center over 19 years. Comparative genomic analysis indicated that patients were...
#1Gwang Myeong Noh (Kosin University)H-Index: 2
#2Ki Yup Nam (Kosin University)H-Index: 10
Last. Sang Joon Lee (Kosin University)H-Index: 11
view all 5 authors...
3 CitationsSource
#1J. Zhu (Chinese PLA General Hospital)H-Index: 3
The aim of this study was to investigate the clinical features and treatment results of endophthalmitis after cataract surgery. Five patients with endophthalmitis after phacoemulsification with intraocular lens implantation were enrolled in this study. The pathogenesis, clinical manifestation, and surgical outcomes of 5 patients were compared. Three patients were surgically treated with anterior chamber irrigation and vitrectomy with intravitreal injection. The remaining two patients were medica...
#1Min Won Ahn (PNU: Pusan National University)H-Index: 2
#2Min Kyu Shin (PNU: Pusan National University)H-Index: 5
Last. Ji Eun Lee (PNU: Pusan National University)H-Index: 19
view all 4 authors...
Purpose: To report 2 cases of recurrent Enterococcus faecalis (E. faecalis) endophthalmitis after uneventful phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Case summary: Case 1: A healthy, 75-year-old female presented with a sudden visual loss and ocular pain 2 days after phacoemulsification and IOL implantation. After successful treatment with intravitreal antibiotics injection, the infection was apparently cleared. At 1 month after the initial presentation, recu...
3 CitationsSource
#1Paulo J. M. Bispo (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 14
#2Wolfgang Haas (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 18
Last. Michael S. Gilmore (MEE: Massachusetts Eye and Ear Infirmary)H-Index: 82
view all 3 authors...
The ability to form biofilms in a variety of environments is a common trait of bacteria, and may represent one of the earliest defenses against predation. Biofilms are multicellular communities usually held together by a polymeric matrix, ranging from capsular material to cell lysate. In a structure that imposes diffusion limits, environmental microgradients arise to which individual bacteria adapt their physiologies, resulting in the gamut of physiological diversity. Additionally, the proximity...
66 CitationsSource