Challenges in Post-cataract Surgery Nocardia Endophthalmitis: Management Strategies and Clinical Outcomes

Zhang

et al. 2022

Front. Public Health

Nocardia endophthalmitis is a relatively uncommon form of endophthalmitis seen in clinical patients. In general, Nocardia endophthalmitis tends to carry a poor prognosis. Here, we report a 3-year-old child who was admitted to the hospital due to a rupture of the left eye. The suturing and anterior chamber formation were performed immediately. Approximately, 16 days after the operation, massive whitish plump and tufted exudates gathered in the pupil area and at the bottom of the anterior chamber, and the child was diagnosed with endophthalmitis. The infection was initially considered to be caused by fungal pathogens for that the hyphae and spores were observed in the smear. However, the isolate obtained after 4 days of culturation was identified as actinomycetes using MALDI–TOF. We further classified it as Nocardia huaxiensis by next-generation sequencing (NGS) based on the MinION platform. Amikacin and sulfamethoxazole tablets were used to control the infection and the ocular inflammation subsided gradually. Intraocular lens (IOL) implantation is planned to be performed at an appropriate future time to improve his vision. Nocardia endophthalmitis is rare and usually caused by ocular trauma or surgery. In conclusion, Nocardia huaxiensis should be considered as an emerging pathogen and deserves more attention.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case Report: First Case of Endophthalmitis Caused by an Emerging Pathogen: Nocardia huaxiensis

Zhang

et al. 2022

Front. Public Health

“…Post-vitrectomy retinal detachment and management of IOL are still controversial in the treatment of APCE [15][16] . Vitrectomy for endophthalmitis has several advantages for patients, such as removing the infected organism, toxins and the infected vitreous that can cause subsequent retinal detachment [17] . Previous studies have shown that vitrectomy with silicone oil tamponade is preferable for post-surgery endophthalmitis [18][19][20][21] .…”

Section: Causative Organismsmentioning

confidence: 99%

Timely vitrectomy without intraocular lens removal for acute endophthalmitis after cataract surgery

Guo¹,

Wang²,

You³

et al. 2022

Int J Ophthalmol

AIM: To investigate the clinical features, causative organisms and effects of timely vitrectomy and silicone oil tamponade without intraocular lens (IOL) removal in the treatment of acute-onset endophthalmitis after cataract surgery (APCE). METHODS: We retrospectively analyzed the clinical features and microbiological factors in 10 eyes of 10 patients with APCE at Tianjin Medical University General Hospital from January 2010 to December 2018. Data on the clinical features, causative organisms, visual acuity, intraocular pressure (IOP) and complications were collected. The mean follow-up period was 25.5mo. RESULTS: The mean age of the patients was 71.4y. The mean time between cataract surgery and the onset of endophthalmitis was 2.0d. Preoperative visual acuity ranged from no light perception to hand motion. After vitrectomy, the visual acuity increased in nine eyes (90%), and was unchanged in one eye (10%). A significant difference was observed between the mean preoperative (36.3±7.1 mm Hg) and postoperative IOP (14.9±4.3 mm Hg, P<0.05). Staphylococcus epidermidis was isolated in 5 eyes, S. aureus in 2 eyes, and Enterococcus in 1 eye. Postoperative complications mainly included fibrin exudates in the anterior chamber at the early stages in all eyes and temporary IOP elevation in one eye. No retinal detachment or ocular atrophy was observed during the follow-up period. CONCLUSION: Under systemic antibiotic treatment and timely diagnosis, vitrectomy and silicone oil tamponade without IOL removal is a safe and effective method for APCE.

“…Rahmani and Eliott also point to the involvement of such species as Enterococcus sp., Proteus sp., or Haemophilus influenzae in endophthalmitis [5]. Infections with opportunistic pathogens belonging to Nocardia sp, among which there are drug-resistant strains, are also possible [6]. Fungal etiology is also likely, and the infection is mainly caused by species of the genus Candida spp., Aspergillus spp., or Fusarium spp.…”

mentioning

confidence: 99%

The eye wipes with polyhexanide (HexaClean) in preoperative prophylaxis of cataract surgery

Rusiecka-Ziółkowska¹,

Hill-Bator²,

Piątkowska³

et al. 2023

Ophthalmol J

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially IntroductIonThe eye, an extremely sensitive organ, is constantly exposed to harmful environmental agents, especially infectious pathogens. The eyelid margin, conjunctiva, and tear film are often a habitat for potentially dangerous microorganisms, which can