García Serrano J L, Domínguez I, Serrano Laborda D
Servicio de Oftalmología, Hospital Universitario de Granada, Spain.
Arch Soc Esp Oftalmol. 2004 Feb;79(2):89-92. doi: 10.4321/s0365-66912004000200010.
OBJECTIVE/METHODS: One month after penetrating keratoplasty, a male patient suffered recurrent abscess and endophthalmitis caused by mixed bacteria (Staphylococcus aureus and Candida Albicans).
Two samples of vitreous and aqueous were taken, and a combination of systemic Vancomycin and Amphotericin B were injected intravitreally. The patient was asymptomatic for a month, but the abscess reactivated and was treated with Vancomycin and Ciprofloxacin administered intravenously. Fifteen days after withdrawing the treatment endophthalmitis returned and was treated with vitrectomy and additional systemic/intravitreal antibiotics and antifungal therapy. The final visual acuity was 20/40.
The delayed vitrectomy proved to be necessary to remove established germs and to eliminate recurrent infections.
目的/方法：穿透性角膜移植术后1个月，一名男性患者因混合细菌（金黄色葡萄球菌和白色念珠菌）感染出现复发性脓肿和眼内炎。
采集两份玻璃体和房水样本，并向玻璃体内注射了全身用万古霉素和两性霉素B的联合制剂。患者在一个月内无症状，但脓肿复发，随后接受静脉注射万古霉素和环丙沙星治疗。停药15天后眼内炎复发，遂进行玻璃体切割术，并追加全身/玻璃体内抗生素和抗真菌治疗。最终视力为20/40。
事实证明，延迟进行玻璃体切割术对于清除已定植的病菌和消除复发性感染是必要的。
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