title: An outbreak of forty five cases of Pseudomonas aeruginosa acute endophthalmitis after phacoemulsification.
abstract: OBJECTIVE
  To describe an outbreak of Pseudomonas aeruginosa endophthalmitis post cataract surgery. Clinical findings, treatment and outcome are discussed.
  
  
  METHODS
  Clinical charts review of forty-five patients treated for endophthalmitis in a two-day period. The patients underwent primary vitrectomy, anterior chamber irrigation and intravitreous antibiotic injection. Cultures from vitreous and anterior chamber samples were performed in all patients.
  
  
  RESULTS
  Forty-five patients (twenty-three men and twenty-two women) were identified. The average age was 71.2 years (range, 56-83 years). The right eye (62%) was affected more often than the left eye (38%). The median interval between surgery and endophthalmitis onset was 5.5 days (range, 5-6 days). The visual acuity at the diagnosis was better than 20/40 in one patient (2%), from 20/40 to 20/200 in one patient (2%), from 20/400 to counting fingers in two patients (4%), hand movements in eleven patients (24%), and light perception in thirty patients (68%). Pseudomonas aeruginosa was the isolated agent in twenty-six vitreous samples and in three anterior chamber samples. Overall, one patient (2%) achieved a final visual acuity better than 20/40; eight patients (18%) achieved a final visual acuity from 20/40 to 20/200; six patients (13%) achieved a final visual acuity from 20/400 to counting fingers; eleven patients (25%) achieved a final acuity of hand movements; thirteen patients (29%) achieved a final acuity of light perception and six (13%) patients had no light perception at the last examination. None of these eyes underwent evisceration or enucleation in a three-month follow-up period.
  
  
  CONCLUSIONS
  Even with all the safety that cataract surgery has achieved, today, endophthalmitis remains a risk and a fearful complication of this procedure. In the present study, it was impossible to identify the source of the outbreak.
authors.affiliation: Department of Ophthalmology, Hospital São Rafael, Fundação Monte Tabor, Salvador (BA), Brazil.
authors.forename: Ricardo Luz Leitão
authors.initials: RL
authors.lastname: Guerra
authors.forename: Bruno de Paula
authors.initials: Bde P
authors.lastname: Freitas
authors.forename: Cintia Maria Felix Medrado
authors.initials: CM
authors.lastname: Parcero
authors.forename: Otacílio de Oliveira
authors.initials: Ode O
authors.lastname: Maia
authors.forename: Roberto Lorens
authors.initials: RL
authors.lastname: Marback
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004196:Disease Outbreaks; D009877:Endophthalmitis / Q000453:epidemiology* / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011552:Pseudomonas Infections / Q000453:epidemiology*; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification; D012189:Retrospective Studies; D014792:Visual Acuity; D014821:Vitrectomy