Clostridium bifermentans panophthalmitis after penetrating eye injury.
BACKGROUND
Intraocular and orbital anaerobic infections usually result from penetrating eye injuries with soil-contaminated foreign bodies. The outcome of these infections almost always has been loss of the globe, despite appropriate antibiotic and surgical treatment. The most prevalent etiologic microbe of anaerobic panophthalmitis is Clostridium perfringens.


METHODS
To the authors' knowledge, this is the first report of panophthalmitis caused by Clostridium bifermentans after penetrating eye injury. The patient had severe signs and symptoms of intraocular and orbital infection, with early total loss of visual function. Parenteral and intravitreal therapy with penicillin and clindamycin, administered according to antibiotic sensitivity studies of cultures from the anterior chamber and vitreous, did not restore vision.


CONCLUSIONS
Due to the early devastating outcome, penetrating eye injuries with soil-contaminated foreign bodies should be regarded as being at high risk for clostridial infection and should be treated promptly with vitrectomy and antibiotic therapy for aerobic and anaerobic infection.
Rehany
U
U
Department of Ophthalmology, Nahariya Medical Center, Israel.
Dorenboim
Y
Y
Lefler
E
E
Schirer
E
E
D000293:Adolescent; D000900:Anti-Bacterial Agents; D003015:Clostridium Infections / Q000188:drug therapy / Q000382:microbiology*; D065306:Corneal Injuries; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005129:Eye Foreign Bodies / Q000150:complications* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D015807:Eye Injuries, Penetrating / Q000150:complications*; D006801:Humans; D008297:Male; D010202:Panophthalmitis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D011859:Radiography; D014792:Visual Acuity
D000900:Anti-Bacterial Agents