Farber B P, Weinbaum D L, Dummer J S
Arch Intern Med. 1985 Jan;145(1):62-4.
Metastatic bacterial endophthalmitis has been reported infrequently in the antibiotic era. We recently encountered five cases of metastatic bacterial endophthalmitis during an eight-month period. The diagnosis was made by blood culture in four of the cases and a positive vitreal aspirate in the fifth case. The organisms included: Staphylococcus aureus, Streptococcus pneumoniae, and groups G and B streptococci. Underlying diseases included endocarditis, lymphoma, and facial trauma. One patient had no identifiable source of infection. The diagnosis was delayed in two of the patients, despite early ophthalmologic consultation. The outcome was poor, four of the five patients lost all useful vision. Development of eye symptoms in the setting of gram-positive bacteremia should be suggestive of this entity. An aggressive diagnostic and therapeutic approach with intravitreal antibiotics might improve the outcome. Our observation of five cases during eight months in one hospital suggests that metastatic endophthalmitis may be more common than is generally appreciated.
在抗生素时代，转移性细菌性眼内炎的报道并不常见。我们最近在八个月的时间里遇到了五例转移性细菌性眼内炎。四例通过血培养确诊，第五例通过玻璃体抽吸物阳性确诊。病原体包括：金黄色葡萄球菌、肺炎链球菌以及G组和B组链球菌。基础疾病包括心内膜炎、淋巴瘤和面部创伤。一名患者没有可识别的感染源。尽管早期进行了眼科会诊，但两名患者的诊断仍被延误。预后很差，五名患者中有四名丧失了所有有用视力。在革兰氏阳性菌血症情况下出现眼部症状应提示存在这种疾病。采用玻璃体腔内注射抗生素的积极诊断和治疗方法可能会改善预后。我们在一家医院八个月内观察到五例病例，这表明转移性眼内炎可能比普遍认为的更为常见。
