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PMID- 29724209
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20180516
IS  - 1471-2415 (Electronic)
IS  - 1471-2415 (Linking)
VI  - 18
IP  - 1
DP  - 2018 May 3
TI  - Microbial keratitis-induced endophthalmitis: incidence, symptoms, therapy, visual
      prognosis and outcomes.
PG  - 112
LID - 10.1186/s12886-018-0777-3 [doi]
AB  - BACKGROUND: To evaluate symptoms, therapies and outcomes in rare microbial
      keratitis-induced endophthalmitis. METHODS: Retrospective study with 11 patients 
      treated between 2009 and 2014. Clinical findings, corneal diseases, history of
      steroids and trauma, use of contact lenses, number and type of surgical
      interventions, determination of causative organisms and visual acuity (VA) were
      evaluated. RESULTS: The incidence of transformation from microbial keratitis to
      an endophthalmitis was 0.29% (n = 11/3773). In 90.9% (n = 10/11), there were
      pre-existent eyelid and corneal problems, in 45.5% (n = 5/11) rubeosis iridis
      with increased intraocular pressure and corneal decompensation, and in 18.2% (n =
      2/11), ocular trauma. Specimens could be obtained in 10 of 11 samples: 33.3% of
      those 10 specimens were Gram-positive coagulase-negative Staphylococci (n = 3/10)
      or Gram-negative rods (n = 3/10) and 10.0% Staphylococcus aureus (n = 1/10). In
      30% (n = 3/10), no pathogens were identifiable. 72.7% (n = 8/11) of all
      keratitis-induced endophthalmitis were treated with vitrectomy and 9.1% (n =
      1/11) with amniotic-membrane transplantation. In 27.3% (n = 3/11) the infected
      eye had to be enucleated - 18.2% (n = 2/11) primarily, 9.1% (n = 1/11)
      secondarily. No patient suffered from sympathetic ophthalmia. The median initial 
      VA was 2.1 logMAR (n = 11/11). At one month, median VA was 2.0 logMAR (n = 7/11),
      after three months 2.0 logMAR (n = 6/11), and after one year 2.05 logMAR (n =
      6/11). The change in VA was not significant (p > 0.99). 36.4% (n = 4/11) of the
      cases resulted in blindness. CONCLUSIONS: The overall outcome is poor.
      Enucleation should be weighed against the risk of local and systemic spread of
      the infection, prolonged rehabilitation and sympathetic ophthalmia.
FAU - Zapp, Daniel
AU  - Zapp D
AD  - Department of Ophthalmology, Klinikum rechts der Isar, Technical University of
      Munich, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Loos, Daria
AU  - Loos D
AD  - Department of Ophthalmology, Klinikum rechts der Isar, Technical University of
      Munich, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Feucht, Nikolaus
AU  - Feucht N
AD  - Department of Ophthalmology, Klinikum rechts der Isar, Technical University of
      Munich, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Khoramnia, Ramin
AU  - Khoramnia R
AD  - Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
FAU - Tandogan, Tamer
AU  - Tandogan T
AD  - Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany.
FAU - Reznicek, Lukas
AU  - Reznicek L
AD  - Department of Ophthalmology, Klinikum rechts der Isar, Technical University of
      Munich, Ismaninger Str. 22, 81675, Munich, Germany.
FAU - Mayer, Christian
AU  - Mayer C
AD  - Department of Ophthalmology, Klinikum rechts der Isar, Technical University of
      Munich, Ismaninger Str. 22, 81675, Munich, Germany. [email protected]
LA  - eng
PT  - Journal Article
DEP - 20180503
PL  - England
TA  - BMC Ophthalmol
JT  - BMC ophthalmology
JID - 100967802
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Steroids)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Endophthalmitis/epidemiology/*etiology/physiopathology/therapy
MH  - Eye Enucleation/statistics & numerical data
MH  - Eye Infections, Bacterial/*complications/epidemiology/microbiology
MH  - Female
MH  - Gram-Negative Bacterial Infections/complications
MH  - Gram-Positive Bacterial Infections/complications
MH  - Humans
MH  - Incidence
MH  - Keratitis/*complications/epidemiology/microbiology
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Steroids/therapeutic use
MH  - Visual Acuity
MH  - Vitrectomy/statistics & numerical data
PMC - PMC5934862
OTO - NOTNLM
OT  - Corneal ulcer
OT  - Endophthalmitis
OT  - Enucleation
OT  - Infection
OT  - Keratitis
EDAT- 2018/05/05 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/05/05 06:00
PHST- 2017/09/06 00:00 [received]
PHST- 2018/04/20 00:00 [accepted]
PHST- 2018/05/05 06:00 [entrez]
PHST- 2018/05/05 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1186/s12886-018-0777-3 [doi]
AID - 10.1186/s12886-018-0777-3 [pii]
PST - epublish
SO  - BMC Ophthalmol. 2018 May 3;18(1):112. doi: 10.1186/s12886-018-0777-3.