Alias Nur-Syifa Athirah Qistina, Bari Muhd-Syafi Abd, Jabbari Aidila Jesmin, Salam Adzura
Department of Ophthalmology, Sultan Ahmad Shah Medical Centre @IIUM, Kuantan, Pahang, Malaysia.
Department of Ophthalmology, Kulliyyah of Medicine, IIUM, Kuantan Campus, Kuantan, Pahang, Malaysia.
Oman J Ophthalmol. 2023 Oct 18;16(3):555-557. doi: 10.4103/ojo.ojo_298_22. eCollection 2023 Sep-Dec.
Endophthalmitis is an uncommon purulent inflammation of the intraocular fluids secondary to endogenous or exogenous causes. It is known that posttraumatic endophthalmitis had a notably poor visual outcome, and it poses therapeutic challenges. Therefore, early organism detection would be beneficial in therapeutic management and are able to reduce long-term complications. This case report describes a patient with a rare positive culture-proven endophthalmitis due to penetrating ocular trauma by a metal brush over the right eye. A 36-year-old man presented with progressively worsening right eye redness and blurring of vision with pain for 3 days following ocular penetration by a metal brush during grinding. On initial presentation, his visual acuity was 6/12 over the right eye and 6/6 over the left eye. His visual acuity deteriorated to hand movement 5 days later with worsening of ocular infection over the right eye despite topical and oral antibiotics. B-scan revealed dense vitreous infiltration. A vitreous tap was done, and a combination of intravitreal vancomycin and ceftazidime was administered. Vitreous culture isolated Gram negative The patient was planned for early vitrectomy; however, the patient opted for conservative treatment. Therefore, the patient received intravitreal vancomycin and intravitreal ceftazidime injections every 48-72 h. Published articles on endophthalmitis postocular penetration are extremely limited. This case report may provide a better understanding of the presentation and is able to aid with early diagnosis and treatment initiation for future reference.
眼内炎是一种由内源性或外源性原因引起的眼内液罕见的化脓性炎症。已知创伤后眼内炎的视力预后明显较差,并且带来治疗挑战。因此,早期病原体检测对治疗管理有益,能够减少长期并发症。本病例报告描述了一名因右眼被金属刷穿透性眼外伤导致罕见的经培养证实的阳性眼内炎患者。一名36岁男性在研磨时右眼被金属刷穿透眼后,出现右眼渐进性发红、视力模糊伴疼痛3天。初诊时,他右眼视力为6/12,左眼视力为6/6。尽管使用了局部和口服抗生素,但5天后他的视力恶化为手动,右眼眼内感染加重。B超显示玻璃体致密浸润。进行了玻璃体穿刺,并给予玻璃体内万古霉素和头孢他啶联合用药。玻璃体培养分离出革兰氏阴性菌。患者原计划早期行玻璃体切除术;然而,患者选择了保守治疗。因此,患者每48 - 72小时接受一次玻璃体内万古霉素和玻璃体内头孢他啶注射。关于眼穿透伤后眼内炎的已发表文章极其有限。本病例报告可能有助于更好地了解其表现,并有助于早期诊断和启动治疗以供未来参考。