title: Bilateral endogenous bacterial endophthalmitis: a report of four cases.
abstract: OBJECTIVE
  To present and discuss four cases of bilateral endogenous endophthalmitis.
  
  
  METHODS
  An observational study of four patients aged 55-80 years, seen within a 2-year period. All had diagnostic and therapeutic vitrectomy. The antibiotic therapy was guided by analyses of cultures of blood and vitreous.
  
  
  RESULTS
  Blood cultures demonstrated Streptococcus pneumoniae in two patients and Staphylococcus aureus and Morganella morganii, each in one patient. The findings corresponded with culture findings from vitreous material in two patients. The primary foci for the metastatic spread of infection were endocarditis, discitis and a subdural abscess of the lumbar spine, urinary tract infection, and infection of a recent hip alloplasty, respectively, in the four patients. Five eyes became blind, whereas three eyes recovered to visual acuity of 0.25-0.67.
  
  
  CONCLUSIONS
  Endogenous bacterial endophthalmitis usually leads to total loss of vision. The disease is acute and the time span for intervention limited. We believe that an active therapeutic approach including intravitreal antibiotics and vitreoretinal surgery saved three eyes from blindness.
authors.affiliation: Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark. rugaard@dadlnet.dk
authors.forename: Steen Rugaard
authors.initials: SR
authors.lastname: Christensen
authors.forename: Ann-Brit Eg
authors.initials: AB
authors.lastname: Hansen
authors.forename: Morten
authors.initials: M
authors.lastname: La Cour
authors.forename: Hans Callø
authors.initials: HC
authors.lastname: Fledelius
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020613:Morganella morganii / Q000302:isolation & purification; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014821:Vitrectomy; D014822:Vitreous Body / Q000187:drug effects / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents