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前房内注射聚维酮碘治疗耐多药外源性眼内炎:病例报告及文献综述

Intracameral Povidone-Iodine for Multidrug-Resistant Exogenous Endophthalmitis: A Case Report and Literature Review.

作者信息

Mohamed Fatma Kassem, Mohamed Mohamed S I, El Shafei Maha M, Pai Anant, Serhan Hashem Abu

机构信息

Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.

College of Medicine, QU Health, Qatar University, Doha, Qatar.

出版信息

Case Rep Ophthalmol. 2025 Jun 5;16(1):468-474. doi: 10.1159/000546659. eCollection 2025 Jan-Dec.

Abstract

INTRODUCTION

The objective of this study was to report successful management of multidrug-resistant endophthalmitis in a patient with a complex ophthalmic history using intracameral povidone-iodine (PI).

CASE PRESENTATION

A 59-year-old male with a history of cataract surgery and multiple retinal detachment repairs presented with acute left eye pain, chemosis, redness, and vision loss. Diagnosis of exogenous endophthalmitis was made. The patient had anterior chamber washout, along with aqueous and vitreous tapping with intravitreal vancomycin, ceftazidime, and intravenous ciprofloxacin. Since infection persisted despite antibiotic therapies, a repeated anterior chamber washout followed by intracameral injection of PI 0.1% was done. Vision improved to 6/60 with no bacterial regrowth or inflammatory membranes on discharge and follow-up.

CONCLUSIONS

Intracameral PI may offer a solution for endophthalmitis cases where standard antibiotics are ineffective. This case supports the potential role of PI in managing resistant intraocular infections.

摘要

引言

本研究的目的是报告使用前房内注射聚维酮碘(PI)成功治疗一名有复杂眼科病史的多药耐药性眼内炎患者。

病例介绍

一名59岁男性,有白内障手术和多次视网膜脱离修复病史,出现左眼急性疼痛、球结膜水肿、眼红和视力丧失。诊断为外源性眼内炎。患者接受了前房冲洗,同时进行房水和玻璃体穿刺,并玻璃体内注射万古霉素、头孢他啶以及静脉注射环丙沙星。尽管进行了抗生素治疗,但感染仍持续存在,于是再次进行前房冲洗,随后前房内注射0.1%的PI。出院时及随访时视力提高到6/60,无细菌再生或炎性膜。

结论

对于标准抗生素治疗无效的眼内炎病例,前房内注射PI可能提供一种解决方案。本病例支持PI在治疗耐药性眼内感染中的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44de/12215200/c4225d70e317/cop-2025-0016-0001-546659_F01.jpg

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