Post vitrectomy endophthalmitis caused by acinetobacter baumanii case report

Session Details

Session Title: Free Paper Session 20: Vitreoretinal Surgery V

Session Date/Time: Sunday 10/09/2017 | 08:00-09:30

Paper Time: 08:12

Venue: Room 117

First Author: : M.Messeha EGYPT

Co Author(s): :                                 

Abstract Details

Purpose:

Although endophthalmitis is rare especially after vitrectomy, ophthalmologists should be alert to the possibility of patients having endophthalmitis caused by A. baumannii after vitrectomy even in presence of silicone oil tamponading. We will describe the clinical course and unusual features of postvitrectomy endophthalmitis after successful phacovitrectomy

Setting:

Al Watany Eye Hospital

Methods:

We report a cases of postoperative endophthalmitis occurred after successful phacovitrectomy with silicone oil tamponading for rhegmatogeneous RD. The primary surgery of phacovitrectomy was uneventful with silicone oil injection. The patient was examined in the 1st postoperative day and the eye was quite white with clear cornea and flat retina with no silicone underfill, no reaction in the anterior chamber and the vision was 0.05 in the 1st postoperative day. After 9 days from 1ry surgery, the patient was presented with sever ocular pain and sudden diminution of vision to PL with hypopyon and +3 cells but clear cornea. US was done for the patient and revealed mild hyperreflectivity in the vitreous cavity and so the patient received medications but the condition became more worse with sever ocular pain and elevation of IOP to 45mmhg and so re-operation was performed immediately with AC wash and silicone oil removal. During silicone removal we noticed the silicone oil appeared clear but after removal of all meniscus of the oil, pure pus with subsilicone exudation was coming out revealing thick biological membranes spreading on the retinal surface. Removal of biological membranes was performed starting from the periphery showing haemorrhagic necrosis of underlying retina.

Results:

The reaction improved on day 7 after secondary surgery and the colour of the retina improved with haemorrhagic patches scattered all over the surface of the retina and also the vision improve to be CF. After 3 weeks the condition continue to improve and the reaction improved in the AC with pigment dispersion on the IOL and posterior synchie and vision continuing improvement to 0.05 after 1 month

Conclusions:

A variety of human infections caused by Acinetobacter species have been reported, including pneumonia, endocarditis, meningitis, skin and wound infections, peritonitis, osteomyelitis, and urinary tract infection. There are few reports of postoperative and posttraumatic endophthalmitis caused by Acinetobacter species Although endophthalmitis caused by A. baumannii is rare, ophthalmologists should be alert to the possibility of endophthalmitis that can occur even after vitrectomy and silicone oil can't prevent bacterial growth.

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