[Endogenous infectious endophthalmitis].
BACKGROUND
Endogenous endophthtalmitis is an intraocular infection of hematogenous origin.


METHODS
It is generally a panuveitis that may be mixed-up with a non-infectious inflammatory disease, promoting delayed treatment and compromising the visual prognosis, as the visual loss rate reaches up to 37.5%. Antibiotherapy should be started immediately after bacteriological examinations and without waiting for vitrectomy. Identification of the causative microorganism is absolutely necessary. It may require aqueous or vitreous culture if cultures from other body fluids are negative and infection progresses. The most common infections are endocarditis and digestive and renal diseases. Virectomy is indicated for first line treatment of ocular abcess and improvement of antibiotic absorption. However, it may lead to retinal detachment. Vitrectomy is also indicated in case of unsuccessful therapy. To decrease the inflammatory reaction and risks of vitreous organization, local or systemic corticotherapy is prescribed after control of the infection.


CONCLUSIONS
Although rare, endogenous endophthalmitis should be diagnosed as it may be mixed-up with inflammatory uveitis, leading to inappropriate corticotherapy. Furthermore, antibiotherapy with good intraocular penetration should be started immediately, but it should be kept in mind that the functional prognosis is poor.
Le Thi Huong
D
D
Service de médecine interne, hôpital de la Pitié-Salpêtrière, Paris, France.
Cassoux
N
N
Kemali
Z
Z
Wechsler
B
B
Blétry
O
O
Le Hoang
P
P
Piette
J C
JC
D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D015242:Ofloxacin / Q000627:therapeutic use; D010068:Oxacillin / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014821:Vitrectomy
D000935:Antifungal Agents; D000666:Amphotericin B; D015242:Ofloxacin; D005437:Flucytosine; D010068:Oxacillin; D012293:Rifampin