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非菌血症患者接受巩膜切开引流和视网膜切除术治疗的社区相关性耐甲氧西林金黄色葡萄球菌眼内脓肿。

COMMUNITY-ASSOCIATED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS SUBRETINAL ABSCESS IN A NONBACTEREMIC PATIENT TREATED WITH INTERNAL DRAINAGE AND RETINECTOMY.

机构信息

Department of Surgery, University of Illinois College of Medicine, Peoria Campus, Peoria, Illinois; and.

Illinois Retina and Eye Associates, Peoria, Illinois.

出版信息

Retin Cases Brief Rep. 2021 Jan 1;15(1):84-88. doi: 10.1097/ICB.0000000000000746.

Abstract

PURPOSE

To report a case of community-associated methicillin-resistant Staphylococcus aureus subretinal abscess that continued to progress, despite intravitreal and systemic antibiotic therapy.

METHODS

Retrospective chart review of a 77-year-old female patient with well-controlled diabetes mellitus who developed a left eye endophthalmitis and subretinal abscess from methicillin-resistant S. aureus colonization in the absence of any systemic focus of infection.

RESULTS

The abscess and endophthalmitis resolved after the second pars plana vitrectomy that included drainage of a subretinal abscess after the failure of initial pars plana vitrectomy, and intravitreal and systemic antibiotics. Retinal detachment due to proliferative vitreoretinopathy necessitated the third pars plana vitrectomy 2 weeks after the second pars plana vitrectomy.

CONCLUSION

The authors present an unusual case of methicillin-resistant S. aureus subretinal abscess in a patient with methicillin-resistant S. aureus colonization with negative blood, aqueous humor culture, and vitreous culture but a positive culture from subretinal aspirate.

摘要

目的

报告一例社区相关性耐甲氧西林金黄色葡萄球菌(MRSA)性眼后段脓肿,尽管进行了玻璃体内和全身抗生素治疗,但仍持续进展。

方法

对一名 77 岁女性患者进行回顾性图表审查,该患者患有糖尿病,血糖控制良好,在无任何全身感染病灶的情况下,由于耐甲氧西林金黄色葡萄球菌定植而发生左眼眼内炎和眼后段脓肿。

结果

在第二次经睫状体平坦部玻璃体切割术(包括初次经睫状体平坦部玻璃体切割术失败后的眼后段脓肿引流)以及玻璃体内和全身应用抗生素后,脓肿和眼内炎得到了缓解。由于增殖性玻璃体视网膜病变导致视网膜脱离,在第二次经睫状体平坦部玻璃体切割术后 2 周时进行了第三次经睫状体平坦部玻璃体切割术。

结论

作者报告了一例耐甲氧西林金黄色葡萄球菌眼后段脓肿的罕见病例,该患者耐甲氧西林金黄色葡萄球菌定植,血、房水和玻璃体液培养均为阴性,但眼后段抽吸物培养为阳性。

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