Leibovitch Igal, Lai Tze, Raymond Grant, Zadeh Ramin, Nathan Francis, Selva Dinesh
Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, South Australia.
Scand J Infect Dis. 2005;37(3):184-9. doi: 10.1080/00365540410020965.
This retrospective report presents a series of patients with endogenous endophthalmitis treated over a 13-y period in a tertiary care centre in South Australia. 16 eyes of 13 patients (8 M, 5 F) with a mean age 62 y were included. Systemic predisposing risk factors were mainly diabetes mellitus (30.7%), chronic obstructive airway disease (23.1%) and end-stage renal disease (15.4%). Isolated organisms included fungal species in 11 eyes (7 eyes with Candida albicans and 4 with Aspergillus fumigatus), Gram-positive isolates in 4 eyes, and Pseudomonas aeruginosa in 1 eyes. Presenting visual acuity was 20/200 or lower in 8 patients (61.5%). Final visual improvement of more than 2 lines was noted in 5 patients, it was stable or worse in 6 patients and in 2 patients the eye was either enucleated or eviscerated. Systemic aspergillosis resulted in death of both patients. In conclusion, the clinical course and microbiological profile of pathogens in patients with endogenous endophthalmitis in our series are similar to other recent western reports. Candida species are the leading isolates, with an overall poor visual prognosis, especially in Aspergillus infections. Close monitoring of immune-compromised patients with systemic infections may enable early diagnosis and treatment and improve prognosis.
本回顾性报告介绍了在南澳大利亚一家三级护理中心13年期间治疗的一系列内源性眼内炎患者。纳入了13例患者（8例男性，5例女性）的16只眼，平均年龄62岁。全身诱发危险因素主要为糖尿病（30.7%）、慢性阻塞性气道疾病（23.1%）和终末期肾病（15.4%）。分离出的病原体包括11只眼中的真菌（7只眼为白色念珠菌，4只眼为烟曲霉）、4只眼中的革兰氏阳性菌和1只眼中的铜绿假单胞菌。8例患者（61.5%）就诊时视力为20/200或更低。5例患者最终视力提高超过2行，6例患者视力稳定或更差，2例患者眼球被摘除或眼内容物剜出。全身性曲霉病导致2例患者死亡。总之，我们系列中内源性眼内炎患者的临床病程和病原体微生物学特征与其他近期西方报告相似。念珠菌属是主要分离出的病原体，总体视力预后较差，尤其是在曲霉感染中。对患有全身感染的免疫功能低下患者进行密切监测可能有助于早期诊断和治疗并改善预后。
