Successful treatment of orthodontic-associated traumatic endophthalmitis.
OBJECTIVE
To report successful management of orthodontic-associated traumatic endophthalmitis.


METHODS
Interventional case report.


METHODS
A 17-year-old boy developed endophthalmitis after a penetrating corneal injury produced during removal of an orthodontic wire. Treatment included pars plana vitrectomy (PPV) with broad-spectrum intravitreal and systemic antibiotics.


RESULTS
Clinical endophthalmitis resolved after PPV with injection of intravitreal vancomycin (1 mg) and ceftazidime (2.25 mg), along with oral ciprofloxacin (750 mg twice daily). Microbiologic cultures of intraocular samples produced Staphylococcus epidermidis, Streptococcus viridans, and Lactobacillus species. Visual acuity improved to 20/20.


CONCLUSIONS
Orthodontic-associated endophthalmitis can involve multiple organisms. It can be successfully treated with current treatment modalities, including PPV, intravitreal antibiotics, and systemic antibiotics.
Wirostko
William J
WJ
Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, USA. wirostko@mcw.edu
Kivlin
Jane D
JD
D000293:Adolescent; D000900:Anti-Bacterial Agents; D003131:Combined Modality Therapy; D065306:Corneal Injuries; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D009877:Endophthalmitis / Q000382:microbiology / Q000628:therapy*; D015818:Eye Infections, Bacterial / Q000382:microbiology / Q000628:therapy*; D015807:Eye Injuries, Penetrating / Q000209:etiology / Q000628:therapy*; D016908:Gram-Positive Bacterial Infections / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D007778:Lactobacillus / Q000302:isolation & purification; D008297:Male; D009969:Orthodontic Wires / Q000009:adverse effects*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D014792:Visual Acuity; D014821:Vitrectomy
D000900:Anti-Bacterial Agents