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1例罕见的与木糖氧化无色杆菌相关的白内障术后急性眼内炎病例

A Rare Case of Acute Post-cataract Surgery Endophthalmitis Associated With Achromobacter xylosoxidans.

作者信息

Wan Dien Tai, Ngah Nor Fariza

机构信息

Ophthalmology, Hospital Shah Alam, Selangor, MYS.

出版信息

Cureus. 2024 Mar 20;16(3):e56527. doi: 10.7759/cureus.56527. eCollection 2024 Mar.

DOI:10.7759/cureus.56527
PMID:38646201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11027173/
Abstract

is rarely reported as a causative agent of post-cataract surgery endophthalmitis. Here, we present a case where timely surgical intervention preserved the patient's vision. A 68-year-old man presented with clinical signs of endophthalmitis in his right eye three days after uneventful cataract surgery. He was initially treated with intravitreal, topical, and systemic antibiotics. After starting intravitreal, topical, and systemic antibiotics, his condition deteriorated on the second day of treatment. A prompt pars plana vitrectomy (PPV) with the removal of the posterior chamber intraocular lens (PCIOL) was performed. Culture from the intravitreal tapping yielded , which was sensitive to ceftazidime and piperacillin. His condition was better post-PPV, and the infection was under control until day 10 post-first PPV. There was a recrudescence of infection with a recurrence of hypopyon and loculations detected on B-scan ultrasound. A second PPV with the complete removal of the lens capsule was performed. One month later, his right eye was quiet without inflammation, with a best-corrected vision of 20/30. is a rare but serious pathogen of endophthalmitis that often necessitates multiple surgical interventions. Although it may not initially respond to intravitreal injections and vitrectomy, appropriate treatment, such as the removal of the intraocular lens and capsulectomy, can still result in favorable visual outcomes.

摘要

作为白内障手术后眼内炎的病原体很少被报道。在此,我们报告一例通过及时手术干预保住患者视力的病例。一名68岁男性在白内障手术顺利完成三天后,右眼出现眼内炎临床症状。他最初接受了玻璃体内、局部和全身抗生素治疗。在开始玻璃体内、局部和全身抗生素治疗后,其病情在治疗第二天恶化。遂立即进行了经平坦部玻璃体切除术(PPV)并取出后房型人工晶状体(PCIOL)。玻璃体内穿刺培养结果为 ,对头孢他啶和哌拉西林敏感。PPV术后他的病情有所好转,感染在首次PPV术后第10天得到控制。B超检查发现感染复发,前房积脓复发且有分隔。遂进行了第二次PPV并彻底切除晶状体囊。一个月后,他的右眼无炎症,最佳矫正视力为20/30。 是一种罕见但严重的眼内炎病原体,常需要多次手术干预。尽管它最初可能对玻璃体内注射和玻璃体切除术无反应,但适当的治疗,如取出人工晶状体和晶状体囊切除术,仍可带来良好的视觉效果。 (注:原文中部分关键信息缺失,已按原样翻译)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b2/11027173/ef04d78ef9e0/cureus-0016-00000056527-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b2/11027173/333c5f740315/cureus-0016-00000056527-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b2/11027173/ef04d78ef9e0/cureus-0016-00000056527-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b2/11027173/333c5f740315/cureus-0016-00000056527-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7b2/11027173/ef04d78ef9e0/cureus-0016-00000056527-i02.jpg

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本文引用的文献

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Delayed-onset endophthalmitis associated with species developed in acute form several months after cataract surgery: Three case reports.白内障手术后数月出现急性形式的与该物种相关的迟发性眼内炎:三例报告。
World J Clin Cases. 2022 Jul 6;10(19):6496-6500. doi: 10.12998/wjcc.v10.i19.6496.
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Int Med Case Rep J. 2020 Jul 9;13:265-269. doi: 10.2147/IMCRJ.S259899. eCollection 2020.
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Achromobacter xylosoxidans bacteremia: clinical and microbiological features in a 10-year case series.
木糖氧化无色杆菌菌血症:10年病例系列的临床和微生物学特征
Rev Esp Quimioter. 2018 Jun;31(3):268-273. Epub 2018 May 23.
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Recurrent Endophthalmitis Caused by Achromobacter xylosoxidans: Importance of Aggressive Surgical Removal of Capsular Bag.木糖氧化无色杆菌引起的复发性眼内炎:积极手术切除囊袋的重要性
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Cornea. 2016 May;35(5):626-30. doi: 10.1097/ICO.0000000000000798.
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Postoperative Alcaligenes xylosoxidans endophthalmitis: report of two cases.术后木糖氧化产碱杆菌眼内炎:两例报告。
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