Triple Gram-negative bacterial endophthalmitis following intravitreal injection.

IF 2.9 Q1 OPHTHALMOLOGY
Samy Zaher, Hector Rodriguez-Villalobos
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引用次数: 0

Abstract

Purpose: To describe a puzzling case of endophthalmitis caused by three unusual bacteria after intravitreal injection, its outcome, and underlying questions.

Findings: A 70-year-old female patient was diagnosed with acute endophthalmitis following intravitreal aflibercept injection for age-related macular degeneration. A standard tap and inject procedure was performed. Microbiological analyses on the anterior chamber and vitreous samples yielded the presence of three non-fermenting Gram-negative rods: Pseudomonas stutzeri, Stenotrophomonas maltophilia, and Ochrobactrum anthropi. The outcome was favorable after intravitreal injections of vancomycin and ceftazidime, with an almost complete recovery of the visual acuity to its baseline level. No potential source of infection was identified.

Conclusion: Endophthalmitis following intravitreal injection can be caused by a wide variety of bacteria, including some rare Gram-negative species. They can sometimes co-exist in a single patient, but their virulence may vary greatly. Due to the variable antibiotic susceptibility and frequent multiresistance associated with non-fermenting Gram-negative rods, a prompt microbiological approach is required. Favorable outcome can be achieved with standard management.

玻璃体内注射后的三重革兰氏阴性菌眼内炎。
目的:描述一例在玻璃体内注射后由三种不同寻常的细菌引起眼内炎的疑难病例、其结果以及潜在的问题:一名 70 岁的女性患者因老年性黄斑变性在玻璃体内注射阿弗利百普后被诊断为急性眼内炎。对患者进行了标准的敲击和注射程序。对前房和玻璃体样本进行微生物学分析后发现了三种非发酵革兰氏阴性杆菌:三种非发酵革兰氏阴性杆菌分别是:Stutzeri 假单胞菌、Stenotrophomonas maltophilia 和 Ochrobactrum anthropi。在玻璃体内注射万古霉素和头孢他啶后,疗效良好,视力几乎完全恢复到基线水平。没有发现潜在的感染源:结论:玻璃体内注射后的眼内炎可由多种细菌引起,包括一些罕见的革兰氏阴性菌。这些细菌有时会同时存在于一名患者体内,但其毒性可能会有很大差异。由于非发酵革兰氏阴性杆菌对抗生素的敏感性不一,而且经常产生多重耐药性,因此需要及时采取微生物治疗方法。规范的治疗可以取得良好的疗效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.80
自引率
3.40%
发文量
39
审稿时长
13 weeks
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