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104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft 2006
Abstract
Abstract
SO.05.01 Endogenous endophthalmitis: distribution of pathogens, primary diseases, therapy and prognosis Kreutzer T. C., Klauss V., Kampik A., Mino de Kaspar H.
Department of Ophthalmology, Ludwig-Maximilians University, Munich Objective: Evaluation of endogenous endophthalmitis cases concerning distribution of pathogens, primary diseases, therapy and prognosis.
Methods: Retrospective analysis of endogenous endophthalmitis cases treated at the eye department of the Ludwig-Maximilians University in Munich between 1990 and 2001.
Results: Thirty-five patients (40 eyes) all suffering of severe diseases were evaluated. In 38 of 40 eyes (95%) causing microorganisms could be detected from vitreous samples. Over half of culture positive cases (22/38) showed fungal infections mostly caused by Candida sp.. Amongst bacterial pathogens Gram-positve Cocci were mostly found. The majority of infected eyes (32/40) were treated with pars plana vitrectomy and intraocula application of antiinfectives. Infections caused by bacterial organisms showed both significantly worse pre and posttherapeutic visual acuity results (P<0.001). Infections caused by Candida sp. were associated with bowel diseases and bowel surgeries, long term intubation and intravenous catheters. Gram-positive Cocci were found in patients with endocarditis, while Gram-negative bacteria were associated with urogenital infections.
Conclusions: Bacterial endogenous endophthalmitis has a significatnly decreased prognosis compared to fungal endogenous endophthalmitis. Primary disease of patients with endogenous endophthalmitis combined with clinical presentation can mostly point at pathogens to be expected. Fast microbiological diagnostics from vitreous samples results in high detection of causing microorganisms
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