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[Pneumococcal postoperative endophthalmitis]
Abstract:
Three cases of pneumococcal endophthalmitis proven by paracentesis and direct bacteriologic evaluation were studied. Cultures were positive for pneumococcus in two the three cases. The fulminant course, and poor visual outcome emphasize the urgency of proper diagnosis by microscopic identification, and of intra-vitreal of injection of antibiotics sometimes associated with vitrectomy. Subconjunctival gentamicin commonly used in ophthalmologic surgery as prophylactic treatment, is often not effective against pneumococcus. It seems advisable to associate subconjunctival chloramphenicol with the gentamicin to help prevent this bacterial infection.
Insights
Pneumococcal endophthalmitis requires prompt diagnosis via microscopic identification and intra-vitreal antibiotics. Standard subconjunctival gentamicin may be insufficient, suggesting chloramphenicol co-administration for effective prevention.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Bacteriology
Background:
- Pneumococcal endophthalmitis is a severe intraocular infection.
- Prompt diagnosis and treatment are crucial for visual outcomes.
Observation:
- Three cases of pneumococcal endophthalmitis were analyzed.
- Cultures confirmed Streptococcus pneumoniae in two cases.
Findings:
- The fulminant disease course and poor visual prognosis highlight diagnostic urgency.
- Microscopic identification and intra-vitreal antibiotic injection, potentially with vitrectomy, are vital.
Implications:
- Subconjunctival gentamicin, a common prophylactic, shows limited efficacy against pneumococcus.
- Combining subconjunctival chloramphenicol with gentamicin may improve prevention of pneumococcal endophthalmitis.