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Endogene Endophthalmitis

Endogenous endophthalmitis

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Summary

Endogenous endophthalmitis is a severe and potentially blinding complication of hematogenous spread of microorganisms. Predisposing factors are intravenous drug abuse, immunosuppression, and prolonged intensive care. Intraocular material needs to be cultured or subjected to PCR to detect the causative microorganisms. In contrast to PCR, culture has the advantage of providing additional information about the resistance of the microorganism. Fungi and bacteria cause endogenous endophthalmitis with the same frequency. Threatment consists in a combination of local and systemic antibiotics or antimycotics, systemic and local corticosteroids, and vitrectomy. The prognosis depends mainly on the initial visual acuity and the pathogen concerned.

Zusammenfassung

Eine endogene Endophthalmitis stellt eine schwere, potenziell zum Verlust des Auges führende Folge einer hämatogenen Aussaat von Keimen dar. Prädisponierende Faktoren sind intravenöser Drogenabusus, Immunsuppression oder eine längere intensivmedizinische Behandlung. Der Keimnachweis sollte durch Kultur oder PCR aus intraokularem Material erfolgen. Die Kultur erlaubt im Gegensatz zur PCR eine Bestimmung des Resistenzspektrums des Keims. Pilze und Bakterien verursachen mit gleicher Häufigkeit eine endogene Endophthalmitis. Zur Therapie kommen Kombinationen aus lokaler und systemischer Antibiotika- oder Antimykotika-Gabe, aus systemischen und lokalen Kortikosteroiden und einer Vitrektomie zum Einsatz. Entscheidend für die Prognose sind der initiale Visus und der auslösende Erreger.

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Literatur

  • Anand A, Madhavan H, Neelam V, et al (2001) Use of polymerase chain reaction in the diagnosis of fungal endophthalmitis. Ophthalmology 108: 326–330

    Article  PubMed  CAS  Google Scholar 

  • Augsten R, Konigsdorffer E, Strobel J (1997) Endogenous endophthalmitis in severe generalized diseases. Ophthalmologe 94: 397–400

    Article  PubMed  CAS  Google Scholar 

  • Bagnoud M, Baglivo E, Hengstler J, et al (2001) Endogenous fungal endophthalmitis: results of antifungal treatment with and without vitrectomy. Klin Monatsbl Augenheilkd 218: 398–400

    Article  PubMed  CAS  Google Scholar 

  • Barza M, Pavan PR, Doft BH, et al (1997) Evaluation of microbiological diagnostic techniques in postoperative endophthalmitis in the Endophthalmitis Vitrectomy Study. Arch Ophthalmol 115: 1142–1150

    PubMed  CAS  Google Scholar 

  • Behrens-Baumann W (2004) Anti-infective drug therapy in ophthalmology – Part 1: bacterial infections. Klin Monatsbl Augenheilkd 221: 539–545

    Article  PubMed  CAS  Google Scholar 

  • Binder MI, Chua J, Kaiser PK, et al (2003) Endogenous endophthalmitis: an 18-year review of culture-positive cases at a tertiary care center. Medicine (Baltimore) 82: 97–105

    Article  Google Scholar 

  • Breit SM, Hariprasad SM, Mieler WF, et al (2005) Management of endogenous fungal endophthalmitis with voriconazole and caspofungin. Am J Ophthalmol 139: 135–140

    Article  PubMed  CAS  Google Scholar 

  • Callegan MC, Engelbert M, Parke DW 2nd, et al (2002) Bacterial endophthalmitis: epidemiology, therapeutics, and bacterium-host interactions. Clin Microbiol Rev 15: 111–124

    Article  PubMed  Google Scholar 

  • Davis JL, Miller DM, Ruiz P (2005) Diagnostic testing of vitrectomy specimens. Am J Ophthalmol 140: 822–829

    Article  PubMed  Google Scholar 

  • Essman TF, Flynn HW Jr, Smiddy WE, et al (1997) Treatment outcomes in a 10-year study of endogenous fungal endophthalmitis. Ophthalmic Surg Lasers 28: 185–194

    PubMed  CAS  Google Scholar 

  • Greenwald MJ, Wohl LG, Sell CH (1986) Metastatic bacterial endophthalmitis: a contemporary reappraisal. Surv Ophthalmol 31: 81–101

    Article  PubMed  CAS  Google Scholar 

  • Jackson TL, Eykyn SJ, Graham EM, et al (2003) Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 48: 403–423

    Article  PubMed  Google Scholar 

  • Joondeph BC, Flynn HW Jr, Miller D, et al (1989) A new culture method for infectious endophthalmitis. Arch Ophthalmol 107: 1334–1337

    PubMed  CAS  Google Scholar 

  • Kostick DA, Foster RE, Lowder CY, et al (1992) Endogenous endophthalmitis caused by Candida albicans in a healthy woman. Am J Ophthalmol 113: 593–595

    PubMed  CAS  Google Scholar 

  • Koul S, Philipson A, Philipson BT (1989) Incidence of endophthalmitis in Sweden. Acta Ophthalmol (Copenh) 67: 499–503

    Article  CAS  Google Scholar 

  • Laube T, Akgul H, Brockmann C, et al (2004) Endogenous bacterial endophthalmitis: a retrospective study on 22 consecutive cases. Klin Monatsbl Augenheilkd 221: 101–108

    Article  PubMed  Google Scholar 

  • Leibovitch I, Lai T, Raymond G, et al (2005) Endogenous endophthalmitis: a 13-year review at a tertiary hospital in South Australia. Scand J Infect Dis 37: 184–189

    Article  PubMed  CAS  Google Scholar 

  • Lohmann CP, Linde HJ, Reischl U (2000) Improved detection of microorganisms by polymerase chain reaction in delayed endophthalmitis after cataract surgery. Ophthalmology 107: 1047–1051; discussion 1051–1052

    Article  PubMed  CAS  Google Scholar 

  • Mino de Kaspar H, Kollmann M, Klauss V (1993) Endophthalmitis. Importance of microbiologic studies for therapy and prognosis. Ophthalmologe 90: 726–736

    PubMed  CAS  Google Scholar 

  • Morlet N, Graham GG, Gatus B, et al (2000) Pharmacokinetics of ciprofloxacin in the human eye: a clinical study and population pharmacokinetic analysis. Antimicrob Agents Chemother 44: 1674–1679

    Article  PubMed  CAS  Google Scholar 

  • Ness T, Pelz K (2000) Endophthalmitis: improvement of culture results. Ophthalmologe 97: 33–37

    Article  PubMed  CAS  Google Scholar 

  • Ness T, Pelz K, Hansen LL: Endogenous endopthalmitis: microorganisms, disposition and prognosis. Acta Ophthalmol (Copenh) (in press)

  • Okada AA, Johnson RP, Liles WC, et al (1994) Endogenous bacterial endophthalmitis. Report of a ten-year retrospective study. Ophthalmology 101: 832–838

    PubMed  CAS  Google Scholar 

  • Okhravi N, Adamson P, Matheson MM, et al (2000) PCR-RFLP-mediated detection and speciation of bacterial species causing endophthalmitis. Invest Ophthalmol Vis Sci 41: 1438–1447

    PubMed  CAS  Google Scholar 

  • Penland RL, Wilhelmus KR (1998) Use of an antimicrobial removal device in endophthalmitis cultures. Retina 18: 169–173

    PubMed  CAS  Google Scholar 

  • Reedy JS, Wood KE (2000) Endogenous Pseudomonas aeruginosa endophthalmitis: a case report and literature review. Intensive Care Med 26: 1386–1389

    Article  PubMed  CAS  Google Scholar 

  • Reinhard T, Bocking A, Sundmacher R (2002) Chronic endophthalmitis mimicking an endothelial immune reaction after penetrating keratoplasty. J Cataract Refract Surg 28: 1475–1477

    Article  PubMed  Google Scholar 

  • Schiedler V, Scott IU, Flynn HW Jr, et al (2004) Culture-proven endogenous endophthalmitis: clinical features and visual acuity outcomes. Am J Ophthalmol 137: 725–731

    PubMed  Google Scholar 

  • Schmitz S, Dick HB, Krummenauer F, et al (1999) Endophthalmitis in cataract surgery: results of a German survey. Ophthalmology 106: 1869–1877

    Article  PubMed  CAS  Google Scholar 

  • Schulman JA, Peyman GA (1992) Intravitreal corticosteroids as an adjunct in the treatment of bacterial and fungal endophthalmitis. A review. Retina 12: 336–340

    Article  PubMed  CAS  Google Scholar 

  • Sharma S, Jalali S, Adiraju MV, et al (1996) Sensitivity and predictability of vitreous cytology, biopsy, and membrane filter culture in endophthalmitis. Retina 16: 525–529

    Article  PubMed  CAS  Google Scholar 

  • Shrader SK, Band JD, Lauter CB, et al (1990) The clinical spectrum of endophthalmitis: incidence, predisposing factors, and features influencing outcome. J Infect Dis 162: 115–120

    PubMed  CAS  Google Scholar 

  • Smiddy WE (1998) Treatment outcomes of endogenous fungal endophthalmitis. Curr Opin Ophthalmol 9: 66–70

    Article  PubMed  CAS  Google Scholar 

  • Smith SR, Kroll AJ, Lou PL, Ryan EA (2007) Endogenous bacterial and fungal endophthalmitis. Int Ophthalmol Clin 47: 173–183

    Article  PubMed  Google Scholar 

  • Takebayashi H, Mizota A, Tanaka M (2005) Relation between stage of endogenous fungal endophthalmitis and prognosis. Graefes Arch Clin Exp Ophthalmol 1–5

  • Tanaka M, Kobayashi Y, Takebayashi H, et al (2001) Analysis of predisposing clinical and laboratory findings for the development of endogenous fungal endophthalmitis. A retrospective 12-year study of 79 eyes of 46 patients. Retina 21: 203–209

    Article  PubMed  CAS  Google Scholar 

  • Thurau S (2003) Practical advice for recovery and successful processing of anterior chamber puncture and vitrectomy samples. Ophthalmologe 100: 802–807

    Article  PubMed  CAS  Google Scholar 

  • Tsai YY, Tseng SH (2001) Risk factors in endophthalmitis leading to evisceration or enucleation. Ophthalmic Surg Lasers 32: 208–212

    PubMed  CAS  Google Scholar 

  • Valluri S, Moorthy RS, Liggett PE, et al (1993) Endogenous Aspergillus endophthalmitis in an immunocompetent individual. Int Ophthalmol 17: 131–135

    Article  PubMed  CAS  Google Scholar 

  • Van Gelder RN (2001) Applications of the polymerase chain reaction to diagnosis of ophthalmic disease. Surv Ophthalmol 46: 248–258

    Article  PubMed  CAS  Google Scholar 

  • Vogt A, Pelz K, Gweon WJ (1975) Improving bacteriological diagnosis by using culture medium during transport of specimens (author's transl). Dtsch Med Wochenschr 100: 1331–1334

    Article  PubMed  CAS  Google Scholar 

  • Wong JS, Chan TK, Lee HM, et al (2000) Endogenous bacterial endophthalmitis: an east Asian experience and a reappraisal of a severe ocular affliction. Ophthalmology 107: 1483–1491

    Article  PubMed  CAS  Google Scholar 

  • Zhang YQ, Wang WJ (2005) Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina 25: 746–750

    Article  PubMed  Google Scholar 

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  1. Universitäts-Augenklinik Freiburg, Germany

    T. Neß

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  1. T. Neß
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Neß, T. Endogene Endophthalmitis. Spektrum Augenheilkd. 22, 4–8 (2008). https://doi.org/10.1007/s00717-008-0243-3

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  • DOI: https://doi.org/10.1007/s00717-008-0243-3

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