Abstract:
Staphylococcus lugdunensis endophthalmitis is an uncommon intraocular infection with potentially visually devastating consequences. S. lugdunensis endophthalmitis have been reported following cataract surgery, trauma, intravitreal injections of anti-vascular endothelial growth factor agents and dexamethasone implant. We report four cases of postoperative S. lugdunensis endophthalmitis after cataract extraction (three patients) and combined pars plana vitrectomy and cataract extraction (one patient). The onset of presentation of endophthalmitis was acute (within 2 weeks) in two patients, subacute (2 to 6 weeks) in one patient, and chronic (more than 6 weeks) in one patient. All patients had presenting visual acuity (VA) of hand motions or worse and were treated with pars plana vitrectomy with intravitreal antibiotics. The final VA was 20/50 in two patients, 4/200 in one patient with pre-existing myopic maculopathy, and no light perception in one patient with retinal detachment. In antibiotic susceptibility testing, S. lugdunensis isolates were resistant to penicillin (3/4, 75%), but all were susceptible to vancomycin, oxacillin, teicoplanin, tigecycline, and sulfamethoxazole-trimethoprim. S. lugdunensis may be associated with acute or chronic endophthalmitis. Favorable visual outcomes can be achieved with prompt diagnosis and management.
摘要:
鲁氏葡萄球菌眼内炎是一种罕见的眼内感染,具有潜在的视觉破坏性后果。据报道,白内障手术后的Lugdunensis眼内炎,创伤,玻璃体内注射抗血管内皮生长因子药物和地塞米松植入物。我们报告了4例白内障摘除术后的Lugdunensis眼内炎(3例)以及平面玻璃体切除术和白内障摘除术(1例)。两名患者出现急性眼内炎(2周内),一名患者的亚急性(2至6周),一名患者患有慢性(超过6周)。所有患者均表现出手部动作的视力(VA)或更差,并接受了玻璃体内抗生素的平坦部玻璃体切除术。两名患者的最终VA为20/50,4/200在一名患有近视性黄斑病变的患者中,一名视网膜脱离患者没有光线感知。在抗生素药敏试验中,蓝藻分离株对青霉素耐药(3/4,75%),但是所有人都对万古霉素敏感,苯唑西林,替考拉宁,替加环素,和磺胺甲恶唑-甲氧苄啶。鲁氏链球菌可能与急性或慢性眼内炎有关。通过及时的诊断和管理可以实现良好的视觉效果。