Exogenous endophthalmitis in pediatric age group.
OBJECTIVE
To identify the microbiological spectrum and visual outcome of exogenous infectious endophthalmitis in the pediatric age group.


METHODS
We reviewed the medical records of all children 14 years and younger with culture-positive endophthalmitis treated at King Khaled Eye Specialist Hospital and King Abdulaziz University Hospital between January 1, 1980, and December 31, 2004.


RESULTS
Forty-nine children were identified. There were 32 males and 17 females with a mean age of 5.7 +/- 2.8 years (range 1-13 years). Thirty-five (71.4 %) cases occurred after penetrating open globe injuries and the remaining 14 (28.6%) followed ocular surgery. Primary vitrectomy was performed on 29 (59.2%) eyes. The mean follow-up was 28.4 +/- 28.4 months (range 1.2-98.5 months). A single species was isolated in 42 (85.7%) eyes, and multiple organisms in seven (14.3%) with a total of 56 infecting organisms. The most common isolates were Streptococcus species and coagulase-negative Staphylococci comprising 44.6% and 21.4% of the isolates, respectively. Final visual acuity was 20/200 or better in 15 (34.1%), counting fingers in 8 (18.2%), light perception to hand motions in 8 (18.2%), no light perception in 13 (29.5%) eyes, including 3 that have been enucleated or eviscerated, and not available in 5 patients. None of the children who had nonvirulent organisms had a final visual acuity of no light perception compared with 39.4% of children who had virulent organisms (p = 0.011). Visual outcome of counting fingers was attained in 26% of children who were treated with primary vitrectomy compared with 5.9% of children treated with antibiotics alone on presentation (p = 0.0484). Visual outcome was no light perception in 18.5% of children who underwent primary vitrectomy compared with 47.1% of children treated with antibiotics alone.


CONCLUSIONS
The most common organisms identified were Streptococcus species and coagulase-negative Staphylococci. Culture of a nonvirulent organism, and treatment with primary vitrectomy were associated with better visual outcomes. Visual outcomes were generally poor.
Al-Rashaed
Saba A
SA
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Abu El-Asrar
Ahmed M
AM
D000293:Adolescent; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D015821:Eye Infections, Fungal / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012529:Saudi Arabia / Q000453:epidemiology; D014792:Visual Acuity