[Endogenous endophthalmitis in severe generalized diseases].
BACKGROUND
In spite of modern antibacterial, antimycotic and operative therapies, endogenous endophthalmitis connected with other severe diseases and an impaired state of health is an eye complication with a very poor prognosis.


METHODS
The study presents observations about the progress of the endogenous endophthalmitis in five eyes of four patients. The age of the patients ranged from 58 to 71 years. The span between the appearance of the first eye symptoms and hospital treatment amounted to 1 week and 3 months. The general diseases have been diagnosed as endometrium cancer, colon cancer, corpus uteri cancer (with intestinal fistula) and pancreatic insufficiency (with subclavian catheter) as well as diabetes mellitus.


RESULTS
In regard to the infections we analyzed (Candida albicans in 3 eyes, bacteria in 2 eyes), very intensive medical treatment was initiated, including antibacterial or antimycotic therapy (local, subconjunctival, intraocular and systemic) as well as pars plana vitrectomy and/or vitreous puncture. Nevertheless, by the end of the clinical attendance, the following statements were established: one-eye enucleation, one-eye evisceration, two eyes perception of light, one eye visual acuity 0.2.


CONCLUSIONS
The patients should be immediately admitted to a hospital with a department for vitreous surgery. Only with this option is it possible to initiate adequate therapy.
Augsten
R
R
Klinik für Augenheilkunde, Friedrich-Schiller-Universität Jena.
Königsdörffer
E
E
Strobel
J
J
D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D009894:Opportunistic Infections / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011379:Prognosis; D014792:Visual Acuity