Ormerod L D, Paton B G, Haaf J, Topping T M, Baker A S
Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.
Ophthalmology. 1987 Jul;94(7):799-808. doi: 10.1016/s0161-6420(87)33532-8.
Eighteen patients with endophthalmitis involving anaerobic bacteria are presented. Endophthalmitis followed cataract surgery in seven patients, penetrating trauma in six, a corneal graft in two, and an infected filtering bleb in two; there was one case of endogenous endophthalmitis. Propionibacterium acnes was the most frequent anaerobe isolated (78% of cases). Thirty-two percent of the patients had polymicrobial infection with mixed aerobic and anaerobic species. Six cases of acute P. acnes endophthalmitis were clinically indistinguishable from other cases of mild to moderately severe endophthalmitis. Four patients presented, after cataract surgery, with chronic, low-grade endophthalmitis of 1 to 15 months' duration, emphasizing that "sterile" endophthalmitis cannot be satisfactory diagnosed clinically. The visual prognosis of treated P. acnes endophthalmitis was often good. Based on principles of anaerobic microbiology, recommendations are made for vitreous collection, transport, and culture.
本文报告了18例由厌氧菌引起的眼内炎患者。7例患者的眼内炎发生在白内障手术后，6例发生于穿透性外伤后，2例发生于角膜移植后，2例发生于感染性滤过泡；另有1例为内源性眼内炎。痤疮丙酸杆菌是最常分离出的厌氧菌（占病例的78%）。32%的患者为需氧菌和厌氧菌混合感染的多微生物感染。6例急性痤疮丙酸杆菌性眼内炎在临床上与其他轻至中度严重眼内炎病例无法区分。4例患者在白内障手术后出现持续1至15个月的慢性、低度眼内炎，强调“无菌性”眼内炎在临床上无法得到满意诊断。经治疗的痤疮丙酸杆菌性眼内炎的视觉预后通常良好。基于厌氧微生物学原理，对玻璃体采集、运输和培养提出了建议。
