Endogenous Serratia marcescens panophthalmitis: A case series.

Autor:	Breazzano MP; Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Edward S. Harkness Eye Institute, Columbia University Medical Center, Department of Ophthalmology, New York University School of Medicine, New York, NY, USA., Jonna G; Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Retina Consultants of Austin, Austin, TX, USA., Nathan NR; Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA., Nickols HH; Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.; Norton Brownsboro Hospital/CPA Laboratory, Louisville, KY, USA., Agarwal A; Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.; West Coast Retina, California Pacific Medical Center, San Francisco, CA, USA.
Jazyk:	angličtina
Zdroj:	American journal of ophthalmology case reports [Am J Ophthalmol Case Rep] 2019 Aug 01; Vol. 16, pp. 100531. Date of Electronic Publication: 2019 Aug 01 (Print Publication: 2019).
DOI:	10.1016/j.ajoc.2019.100531
Abstrakt:	Purpose: - Two rare and unusual cases of endogenous panophthalmitis from Serratia marcescens are presented with mechanisms for infection explored. Observations - The first patient had history of intravenous drug use (IVDU) without any medical implants. The second patient, in addition to IVDU, had a history of end-stage renal disease with upper extremity arteriovenous fistula graft infection from Serratia marcescens confirmed by wound culture. One patient had a history of licking the needles prior to IV drug injection. Clinical exam in both cases revealed light perception vision, relative afferent pupillary defect, periorbital edema with limited extraocular motility, and hypopyon in the affected eyes. Cultures from the anterior chamber aspirate were positive for Serratia marcescens in the first case and demonstrated Gram-negative rods in the second. Attempted vitreous aspiration was unsuccessful at obtaining specimens. Computed tomography demonstrated orbital fat stranding without abscess, and histopathology showed intense neutrophilic infiltration in all layers of enucleated specimen in case one. Conclusions and Importance: Needle licking may be an underappreciated mechanism for endogenous endophthalmitis in intravenous drug users. This report includes the first case in the literature, to authors' knowledge, of non-nosocomial endogenous Serratia marcescens panophthalmitis with orbital cellulitis. The second case illustrates a rare consequence of the rise in arteriovenous fistula placement and dialysis across the United States, which may predispose to future cases of endogenous Serratia marcescens endophthalmitis. This series supports previous observations of Serratia marcescens endogenous endophthalmitis exhibiting a generally poor visual prognosis.
Databáze:	MEDLINE
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