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Paediatric post-traumatic endophthalmitis
D V Alfaro1, D B Roth, R M Laughlin
1Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4799, USA.
Insights
Early, aggressive treatment can restore useful vision in children with post-traumatic endophthalmitis. Paediatric cases show different microbiology, with streptococcal species being the most common cause, unlike in adults.
Area of Science:
- Ophthalmology
- Microbiology
- Pediatrics
Background:
- Post-traumatic endophthalmitis (PTE) is a severe intraocular infection following eye injury.
- Understanding microbiological differences in pediatric PTE is crucial for effective management.
Purpose of the Study:
- To analyze the microbiological characteristics of PTE in children.
- To compare pediatric PTE microbiology with that of adult cases.
Main Methods:
- Retrospective analysis of 12 pediatric PTE cases (ages 18 months to 13 years).
- Microbiological cultures and analysis of causative organisms.
- Review of treatment modalities, including vitrectomy, and visual outcomes.
Main Results:
- Streptococcal species (56.6%) and staphylococcal species (22.2%) were the most common isolates.
- Gram-positive organisms were predominant (8/12 eyes).
- Good visual acuity (≥20/200) was achieved in 66.7% of eyes.
Conclusions:
- Early and aggressive treatment can lead to useful vision in pediatric PTE.
- Pediatric PTE microbiology differs significantly from adult PTE, with streptococci being more prevalent.
Aims:
A retrospective analysis of children with post-traumatic endophthalmitis was performed to determine if microbiological differences exist between this disease in the paediatric population compared with this disease in adults.
Method:
Twelve cases of post-traumatic endophthalmitis in children were analysed to determine characteristics of this disease in youth. Patient ages varied from 18 months to 13 years; the mean age was 8 years. Gram positive organisms were isolated in eight eyes, Gram negative organisms from four eyes, fungus from one eye, and negative cultures in three eyes. The most common isolates were streptococcal species (56.6%) and staphylococcal species (22.2%). Vitrectomy was performed on eight (66.7%) eyes.
Results:
Visual acuity of 20/200 or better was obtained in eight eyes (66.7%). Three eyes had vision less than 5/200. One eye developed phthisis bulbi. Nine (75%) patients were younger than 10 years of age, and six (66.7%) of these nine obtained a final visual acuity of 20/200 or better.
Conclusion:
Useful vision can be obtained in children with post-traumatic endophthalmitis with early, aggressive treatment. The microbiology of paediatric post-traumatic endophthalmitis differs from adult disease with streptococcal species as the most common infecting organisms.