Endogenous endophthalmitis: microorganisms, disposition and prognosis.
OBJECTIVE
Endogenous endophthalmitis is a severe and potentially blinding complication caused by haematogenous spreading of microorganisms. We evaluated the causative microorganisms, disposition to and prognosis of the disease.


METHODS
Thirty-one eyes of 28 patients were treated between 1996 and 2006 as the result of an endogenous endophthalmitis.


RESULTS
The microorganisms responsible for infection could be identified in 94% of all eyes investigated. Candida isolates were obtained in 15, gram-positive isolates in 11, gram-negative in one and Aspergillus in two of the 29 eyes studied. The majority of patients suffered from severe general disease (immuno-deficiency, severe surgical procedures, diabetes mellitus) and one third were intravenous drug abusers. Only one patient was otherwise healthy. The prognosis depended on the causative microorganisms. Whereas none of the eyes with Candida infection became blind, all except two of the eyes with gram-positive bacteria, Nocardia or Aspergillus infection lost visual function or had to be enucleated.


CONCLUSIONS
Compared to postoperative endophthalmitis, patients with endogenous endophthalmitis are more likely to have Candida isolates. Visual prognosis depends mainly on the underlying microorganisms, and is particularly poor in the case of infection with gram-positive bacteria or Aspergillus.
Ness
Thomas
T
Department of Ophthalmology, University of Freiburg, Freiburg, Germany. thomas.ness@uniklinik-freiburg.de
Pelz
Klaus
K
Hansen
Lutz Lothar
LL
D000293:Adolescent; D000328:Adult; D000368:Aged; D001228:Aspergillosis; D001766:Blindness / Q000209:etiology; D002177:Candidiasis; D002648:Child; D002675:Child, Preschool; D009877:Endophthalmitis / Q000150:complications* / Q000382:microbiology*; D015818:Eye Infections, Bacterial; D015821:Eye Infections, Fungal; D005260:Female; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology*