Istituto Clinico San Rocco, Brescia, Italy.
IRCCS-Fondazione Bietti, Rome, Italy.
Eur J Ophthalmol. 2021 Jan;31(1):NP9-NP12. doi: 10.1177/1120672119878016. Epub 2019 Sep 25.
To describe the first case of endophthalmitis caused by , a glucose non-fermenting Gram-negative rod, in a patient previously implanted with a Xen gel stent.
An 83-year-old patient, affected by open-angle glaucoma and with a previous surgery of combined cataract extraction and Xen gel stent implantation, developed endophthalmitis 1 month after bleb needle revision with 5-fluorouracil injection. At presentation, best corrected visual acuity was hand movement, hypopyon was evident into the anterior chamber and a flat bleb with no sign of leakage was present over the Xen gel implant.
Immediate pars plana vitrectomy was performed, with intravitreal antibiotic administration and silicon oil tamponade. was isolated from vitreous bacterial culture. According to the antibiogram, patient was treated with topical fortified ceftazidime eyedrops and appropriate systemic antibiotics (intravenous meropenem, 500 mg every 8 h for 7 days, followed by oral cotrimoxazole, 160 + 800 mg, twice a day for 10 days). After 2 weeks of treatment, ocular inflammation was resolved, best corrected visual acuity was 0.1 (Snellen chart) and intraocular pressure was 18 mm Hg without topical hypotensive therapy.
was isolated for the first time as a causative agent of endophthalmitis in humans. Bleb needle revision in patients with Xen gel implant is not free of complications, and an attentive follow-up is required.
描述首例由 引起的眼内炎病例，该病原体是一种不发酵葡萄糖的革兰氏阴性杆菌，患者先前植入了 Xen 凝胶支架。
一位 83 岁患者，患有开角型青光眼，曾行白内障超声乳化联合 Xen 凝胶支架植入术，在 bleb 针用 5-氟尿嘧啶注射进行修订后 1 个月发生眼内炎。就诊时，最佳矫正视力为手动，前房有明显积脓，Xen 凝胶植入物上方的 bleb 平坦且无渗漏迹象。
立即进行了经睫状体平坦部玻璃体切除术，并给予玻璃体内抗生素治疗和硅油填充。从玻璃体细菌培养中分离出 。根据药敏试验结果，患者接受了局部强化头孢他啶滴眼剂和适当的全身抗生素治疗（静脉注射美罗培南，500mg，每 8 小时 1 次，共 7 天，随后口服复方磺胺甲噁唑，160+800mg，每天 2 次，共 10 天）。治疗 2 周后，眼部炎症得到缓解，最佳矫正视力为 0.1（Snellen 图表），眼内压为 18mmHg，无需局部降压治疗。
首次分离出 作为人类眼内炎的致病因子。在 Xen 凝胶植入物患者中进行 bleb 针修订并非没有并发症，需要进行密切随访。
