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Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India

PURPOSE: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. METHODS: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. RESULTS: In our study, 41 e...

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Autores principales: Pillai, Gopal S, Remadevi, Kiran Krishnankutty, Anilkumar, V, Radhakrishnan, Natasha, Rasheed, Rehna, Ravindran, Greeshma C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350495/
https://www.ncbi.nlm.nih.gov/pubmed/32317455
http://dx.doi.org/10.4103/ijo.IJO_948_19
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author Pillai, Gopal S
Remadevi, Kiran Krishnankutty
Anilkumar, V
Radhakrishnan, Natasha
Rasheed, Rehna
Ravindran, Greeshma C
author_facet Pillai, Gopal S
Remadevi, Kiran Krishnankutty
Anilkumar, V
Radhakrishnan, Natasha
Rasheed, Rehna
Ravindran, Greeshma C
author_sort Pillai, Gopal S
collection PubMed
description PURPOSE: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. METHODS: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. RESULTS: In our study, 41 eyes of 34 patients were included. Most common co-morbidity associated with endogenous endophthalmitis was Diabetes Mellitus (70.7%) and most common infective foci was UTI (73.2%). Among the culture positive cases, fungi and bacteria were evenly distributed, 76.93% were Gram positive bacteria and 23.07% were Gram negative. Fungal endogenous endophthalmitis was more commonly seen in immunosuppressed state (72.7%) and bilateral cases (66.7%). The mean presenting vision (log MAR) of patients who died during the study were poor compared to those who survived (P = 0.014) Poor mean visual acuity at presentation was associated with more death (P = 0.014). Eyes with poor presenting vision, fungal isolates, culture positivity and immune suppression had poor visual and survival outcome. Poor visual outcome was observed more frequently in eyes with Aspergillus infection (85.7%) compared to Candida (75%) and bacteria (58.3%). Evisceration was done for 5 out of 41 eyes (12.2%). Vitrectomy rate was 53.7% in our study, with 40% of them showing overall improvement in vision. CONCLUSION: Endogenous endophthalmitis is a sight threatening condition associated with high mortality particularly when caused by Aspergillus spp. in immunocompromised patients. Contrary to the prior published reports of endogenous endophthalmitis outside India, we found an equal distribution of fungal and bacterial organisms among our cases, with predominance of Aspergillus among fungal isolates and Gram-positive organism among bacteria. Fungal infections, especially with Aspergillus spp., resulted in poor visual and survival outcome.
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spelling pubmed-73504952020-07-15 Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India Pillai, Gopal S Remadevi, Kiran Krishnankutty Anilkumar, V Radhakrishnan, Natasha Rasheed, Rehna Ravindran, Greeshma C Indian J Ophthalmol Original Article PURPOSE: The purpose of this study is to evaluate the clinical profile, visual, anatomical and survival outcome of patients with endogenous endophthalmitis. METHODS: Retrospective chart review of consecutive cases with endogenous endophthalmitis presenting from 2009-2016. RESULTS: In our study, 41 eyes of 34 patients were included. Most common co-morbidity associated with endogenous endophthalmitis was Diabetes Mellitus (70.7%) and most common infective foci was UTI (73.2%). Among the culture positive cases, fungi and bacteria were evenly distributed, 76.93% were Gram positive bacteria and 23.07% were Gram negative. Fungal endogenous endophthalmitis was more commonly seen in immunosuppressed state (72.7%) and bilateral cases (66.7%). The mean presenting vision (log MAR) of patients who died during the study were poor compared to those who survived (P = 0.014) Poor mean visual acuity at presentation was associated with more death (P = 0.014). Eyes with poor presenting vision, fungal isolates, culture positivity and immune suppression had poor visual and survival outcome. Poor visual outcome was observed more frequently in eyes with Aspergillus infection (85.7%) compared to Candida (75%) and bacteria (58.3%). Evisceration was done for 5 out of 41 eyes (12.2%). Vitrectomy rate was 53.7% in our study, with 40% of them showing overall improvement in vision. CONCLUSION: Endogenous endophthalmitis is a sight threatening condition associated with high mortality particularly when caused by Aspergillus spp. in immunocompromised patients. Contrary to the prior published reports of endogenous endophthalmitis outside India, we found an equal distribution of fungal and bacterial organisms among our cases, with predominance of Aspergillus among fungal isolates and Gram-positive organism among bacteria. Fungal infections, especially with Aspergillus spp., resulted in poor visual and survival outcome. Wolters Kluwer - Medknow 2020-05 2020-04-20 /pmc/articles/PMC7350495/ /pubmed/32317455 http://dx.doi.org/10.4103/ijo.IJO_948_19 Text en Copyright: © 2020 Indian Journal of Ophthalmology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Pillai, Gopal S
Remadevi, Kiran Krishnankutty
Anilkumar, V
Radhakrishnan, Natasha
Rasheed, Rehna
Ravindran, Greeshma C
Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title_full Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title_fullStr Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title_full_unstemmed Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title_short Clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in South India
title_sort clinical profile and outcome of endogenous endophthalmitis at a quaternary referral centre in south india
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7350495/
https://www.ncbi.nlm.nih.gov/pubmed/32317455
http://dx.doi.org/10.4103/ijo.IJO_948_19
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