Weinstein G S, Mondino B J, Weinberg R J, Biglan A W
Ann Ophthalmol. 1979 Jun;11(6):935-43.
A study of 22 consecutive cases of suspected endophthalmitis in children disclosed that 68% (15/22) were male with a mean age of 7.4 years. In contrast to adult populations, 86% (19/22) followed trauma in this series. Cultures were performed in 18 cases yielding positive results in 8 cases. Anterior chamber paracentesis was positive in 6/10 attempts, vitreous cultures in 1/4, and wound cultures in 2/7. Gram-positive organisms were recovered in 75% (6/8) of the cultures, stressing the importance of coverage for these organisms before culture results are known. Although cultures should be obtained as soon as possible, the initiation of antibiotics beforehand should not deter one from obtaining cultures as 75% (6/8) of patients with positive cultures had preculture antibiotics. Fourteen patients were diagnosed within 48 hours of the precipitating event, and all of these cases followed trauma. Three of 7 patients with positive cultures and 1 of 10 patients with negative cultures had final visual acuities of 20/200 or better. The lack of correlation between a positive culture and a poor visual outcome suggests that the final visual acuity depends not only on the endophthalmitis, but also on the extent of trauma.
一项针对22例疑似儿童眼内炎的连续病例研究表明，68%（15/22）为男性，平均年龄7.4岁。与成人患者不同，该系列病例中86%（19/22）继发于外伤。18例进行了培养，8例结果呈阳性。前房穿刺10次中有6次呈阳性，玻璃体培养4次中有1次呈阳性，伤口培养7次中有2次呈阳性。75%（6/8）的培养物中分离出革兰氏阳性菌，这凸显了在培养结果出来之前覆盖这些细菌的重要性。尽管应尽快进行培养，但提前使用抗生素不应妨碍获取培养物，因为75%（6/8）培养结果呈阳性的患者在培养前已使用了抗生素。14例患者在引发事件后48小时内得到诊断，所有这些病例均继发于外伤。7例培养结果呈阳性的患者中有3例，10例培养结果呈阴性的患者中有1例，最终视力达到20/200或更好。培养结果呈阳性与视力不良之间缺乏相关性，这表明最终视力不仅取决于眼内炎，还取决于外伤的程度。
