[Postoperative infections in systemic immunocompromising diseases. A study of 6 patients]

Advances of therapeutic strategies in the management of critically ill patients have resulted in an increased life expectancy and more frequent presentations to ophthalmic surgeons. Six patients with postoperative endophthalmitis after elective intraocular surgery suffering from Sharp-syndrome, metastasizing antrum carcinoma, granulomatous vasculitis and immunosuppressive therapy, agranulocytosis, silico-tuberculosis and chronic lymphatic leukemia revealed traditionally pathogenic agents (Proteus mirabilis, P. aeruginosa, enterococci, coagulase-negative Staph). Two patients had to be enucleated, one turned blind and three had a visual acuity 5/100 to 20/60. In our hands prognosis for successful therapy in immunodeficient patients seems worse than in otherwise healthy persons. Painstaking evaluation of history, medical work-up, conjunctival swabs and application of bactericidal topical antibiotics preoperatively and perioperatively are particularly important in these patients.