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Posttraumatic endophthalmitis: the emerging role of Bacillus cereus infection
Abstract:
Endophthalmitis resulting from nonsurgical penetrating trauma to the eye is a relatively uncommon infection in the United States. Data are limited, but most recently published series have attributed the highest incidence of infection to gram-positive organisms, in particular Staphylococcus epidermidis. Fungal causes have been reported far less frequently. Bacillus species are being recognized increasingly as major causes of posttraumatic ocular disease, with rates of infection often making them the second most commonly isolated organisms. Bacillus cereus, an especially virulent pathogen, causes a fulminant endophthalmitis characterized by rapid destruction of intravitreal contents and a uniformly poor visual outcome. Certain toxins elaborated by the organism may contribute to its particular virulence. The currently recommended approach to suspected posttraumatic infection involves early use of diagnostic vitrectomy and intraocular culture, use of intravitreal antibiotics, and combination treatment with systemic and periocular antibiotics.
Insights
Nonsurgical penetrating eye trauma can cause endophthalmitis, with Bacillus cereus emerging as a virulent pathogen. Early diagnosis and treatment with antibiotics are crucial for managing this severe ocular infection.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Endophthalmitis following nonsurgical penetrating eye trauma is rare in the US.
- Gram-positive organisms, especially Staphylococcus epidermidis, are common causes.
- Fungal infections are less frequent, while Bacillus species are increasingly recognized.
Observation:
- Bacillus species are the second most common cause of posttraumatic ocular infections.
- Bacillus cereus causes a severe, rapidly progressing endophthalmitis.
- This pathogen's virulence may be linked to specific toxins.
Findings:
- Bacillus cereus endophthalmitis leads to rapid destruction of intraocular contents.
- Visual outcomes are consistently poor in Bacillus cereus infections.
- Diagnostic vitrectomy, intraocular cultures, and prompt antibiotic therapy are recommended.
Implications:
- Understanding the role of Bacillus cereus in posttraumatic endophthalmitis is critical.
- Prompt and aggressive treatment strategies are necessary to improve visual outcomes.
- Further research into Bacillus cereus virulence factors may inform novel therapeutic approaches.