Endogenous endophthalmitis in children and adolescents: Case series and literature review

Aditya Maitray, Ekta Rishi, Pukhraj Rishi, Lingam Gopal, Pramod Bhende, Rupak Ray, Kuzhanthai Therese

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Purpose: To study the clinical and microbiological profile, treatment modalities, and anatomical and functional outcomes among children and adolescents with endogenous endophthalmitis (EE) at a tertiary eye care centre in India. Methods: Medical records of subjects <18 years, presenting with EE from 1997 to 2007 were reviewed. Cases where the causative organism was identified were included. Treatment regimen included systemic antibiotics, vitrectomy, intravitreal antibiotics, and enucleation. Systemic evaluation to identify the source of infection was done by an internist. Microbiological analysis of blood, urine, and ocular specimens was done. The favorable anatomical outcome was defined as the attached retina, with controlled intraocular pressure and clear media at the last follow up. The favorable functional outcome was defined as vision >3/60 on the final follow up. Univariate regression analysis was done to identify factors predicting functional outcome. Results: Thirty eyes of 30 subjects (23 (77%) males) were studied. The mean age at presentation was 6.8 years (range=1-16 years). Fever was evident in four (13%) and blood culture was negative in all cases. Gram-positive organisms were identified in 11 (37%) eyes, fungi in 3 (10%), and toxocara in 8 (27%) eyes. Twenty-three (77%) eyes underwent vitrectomy. Favorable functional and anatomical outcomes were achieved in 9 (30%) and 12 (40%) eyes, respectively. Eyes undergoing vitrectomy showed significant correlation with good functional outcome (P = 0.05). Conclusion: EE is under-reported and not well studied in children. The absence of systemic features may be evident in a developing country with over the counter availability of antibiotics. Gram-positive infections are common and vitrectomy is a beneficial modality of treatment.

Original languageEnglish (US)
Pages (from-to)795-800
Number of pages6
JournalIndian Journal of Ophthalmology
Volume67
Issue number6
DOIs
StatePublished - Jun 2019
Externally publishedYes

Keywords

  • Children
  • endogenous endophthalmitis
  • vitrectomy

ASJC Scopus subject areas

  • Ophthalmology

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