Diagnosis and therapy of bacterial endophthalmitis, and serum levels of inflammation markers.

A review of 27 cases of bacterial endophthalmitis diagnosed and treated at the Specialized Outpatient Department for Infectious Eye Diseases at the 2nd Department of Ophthalmology of the University of Vienna over a period of eight years (January 1983-April 1991) is presented. In 70% of the cases the patients had undergone surgical intervention. Conjunctival samples were routinely taken for microbiological investigations (aerobic as well as anaerobic cultures). In 19 patients (70.4%) aqueous specimens were obtained, in 22 cases (81.5%) vitreous specimens collected during vitrectomy for the removal of infected material were used for microbiological diagnosis. The results for the patient population described showed the poor reliability of conjunctival cultures from intraocular infections with only 36.84% being identical with those of the vitreous specimens. In the most recent 11 patients three serological parameters of inflammation were tested on various occasions: C-reactive protein, PMN- elastase and light immunoglobulin chain assembling (kappa/lambda). Clinical results, microbiological findings and therapeutic approaches are presented and discussed.