Abstract:
METHODS: 49-year-old man with diabetic macular edema refractory to antiangiogenics, it is decided to perform therapy with intravitreal dexamethasone implant (Ozurdex; Allergan, California, United States of America). Seven days after treatment, he showed acute endophthalmitis suggestive signs. Despite the intravitreal injection of antibiotics, the patient got worse. Vitreous sampling was repeated for Gram and cultures, and vitrectomy was performed via pars plana. The culture suggested the development of Brevibacterium species. Through an additional test, the presence of Brevibacterium casei was confirmed. Despite the treatment adjusted by antibiogram, retinal ischemia and macular atrophy was evident.
CONCLUSIONS: Brevibacterium casei is a Gram-positive bacterium, barely pathogenic, that mainly affects immunodepressed patients. Only two cases of endophthalmitis are described, one endogenous and the other one secondary to vegetal trauma. This is the first case of endophthalmitis, secondary to an ophthalmological procedure.
摘要:
方法:49岁男性患有抗血管生成药物难治性糖尿病性黄斑水肿,决定使用玻璃体内地塞米松植入物进行治疗(Ozurdex;Allergan,加州,美利坚合众国)。治疗后七天,他表现出急性眼内炎的暗示体征。尽管玻璃体内注射了抗生素,病人变得更糟。对革兰氏和培养物重复玻璃体取样,玻璃体切除术是通过平坦部进行的。培养表明短杆菌物种的发育。通过额外的测试,确认了干酪短杆菌的存在。尽管通过抗生素分析调整了治疗方法,视网膜缺血和黄斑萎缩明显。
结论:干酪短杆菌是革兰氏阳性细菌,几乎没有致病性,主要影响免疫抑制患者。仅描述了两例眼内炎,一种是内源性的,另一种是继发于植物创伤。这是第一例眼内炎,继发于眼科手术。