Fungal Endophthalmitis After a Single Intravenous Administration of Presumably Contaminated Dextrose Infusion Fluid

Gupta, Amod; Gupta, Vishali; Dogra, Mangat R; CHAKRABARTI, ARUNALOKE; RAY, PALLAB; Ram, Jagat; Patnaik, Bijayananda

doi:10.1097/00006982-200003000-00007

Cited by 48 publications

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“…They speculate that PPV may have provided a better overall cosmetic outcome, limiting globe shrinkage. Gupta et al showed that eyes that undergo pars plana vitrectomy are three times more likely to retain useful vision and three times less likely to require evisceration and enucleation [19]. However, Wu et al did not observe any significant benefit of vitrectomy on visual outcome in all postoperative (any intraocular surgery) endophthalmitis cases [10].…”

Section: Vitreous Biopsy and Culture Resultsmentioning

confidence: 99%

Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center

2007

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Cataract surgery remains the most common cause of endophthalmitis in this large tertiary referral retina center. Endophthalmitis resolved with vitreous needle biopsy and intravitreal injections in more than half of the cases. However, more than a third of patients required additional vitreoretinal surgery for secondary complications. More than a third of patients had nonfunctional vision after the resolution of endophthalmitis, which highlights the severity of this condition in the current expanding era of office-based intravitreal pharmacotherapy for retinal diseases.

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Section: Vitreous Biopsy and Culture Resultsmentioning

confidence: 99%

Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center

2007

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“…We have previously reported 12 cases of endogenous fungal endophthalmitis in patients with minor ailments who had received presumably contaminated dextrose infusions prior to the ocular involvement [9]. We presume that, in this case also, the dextrose infusions which the patient received a week earlier while undergoing a surgical procedure for hydrocele was contaminated with the causative fungus.…”

Section: Discussionmentioning

confidence: 79%

Endogenous mycotic endophthalmitis in an immunocompetent patient

et al. 2008

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Acute and invasive fungal infections are usually seen in immunocompromised and debilitated patients. We report a young immunocompetent 28-year-old Indian male who presented with unilateral endogenous endophthalmitis in the left eye and was managed with pars plana vitreous surgery. The polymerase chain reaction from the vitrectomy specimen tested positive for the fungal genome while the cytology examination identified aseptate hyphae with wide-angle branching, most likely suggesting Zygomycosis. A detailed systemic evaluation failed to reveal any systemic focus or predisposing factor for fungal infection. The patient had received intravenous dextrose infusions while undergoing a surgical procedure for post-traumatic hydrocele elsewhere a week prior to this episode. The patient was successfully managed with pars plana vitreous surgery along with intravitreal Amphotericin-B and oral Voriconazole.

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“…8 Gram negative organisms like E. coli, N. meningitidis and Klebsiella have been reported to cause endogenous endophthalmitis 9,10 Though the endophthalmitis occurs more commonly in immunocompromised patients, many studies have shown its occurrence in systemically well patients. Gupta et al 4 12 in 2011 reported severe endogenous endophthalmitis caused by Staphahylococcus epidermidis in a systemically well individual. In addition to routine laboratory tests testing for HIV infection should be done in otherwise healthy persons with endogenous endophthalmitis.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Common fungal isolates are Candida and Aspergillus. 4 We report a case of endogenous endophthalmitis in an immunocompetent subject after intravenous fluid therapy for gastroenteritis. …”

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confidence: 96%

“…Dental surgery, contaminated intravenous fluids, enteric fever, gastroenteritis and intravesicular injections of M.bovis or Bacillus Calmette Guerin for bladder carcinoma have been reported as risk factors in the immunocompetent subjects. [3][4][5] The common causative organisms include Staphylococcus aureus and Streptococcus pneumonia. Although cases of Pseudomonas and Klebsiella endophthalmitis have been reported among immunocompetent subjects.…”

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Contaminated Dextrose Normal Saline: A Cause of Endogenous Endophthalmitis in an Immunocompetent Subject

Chaudhry¹

2012

DJO

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Endogenous endophthalmitis is an intraocular infection caused by haematogenous spread of microorganisms from distant foci. It accounts for 2-8% of all cases of endophthalmitis. The common causative organisms include Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas andEndogenous Endophthalmitis is relatively rare but sight threatening intraocular infection caused by haematogenous spread of micro organisms from a distant focus of infection elsewhere in the body. It accounts for 2-8% of all cases of endophthalmitis.1 It can affect patients of any age or sex. Endogenous endophthalmitis usually occurs in immunocomromised subjects although cases have been reported among immunocompetent patients. The predisposing factors include chronic metabolic diseases like diabetes mellitus, chronic renal failure, malignancy, acquired immuno deficiency syndrome (AIDS), intravenous drug abuse or after invasive procedures.2 Studies have reported that nearly 90% cases of endogenous endophthalmitis occur in patients having some or the other predisposing factor but increasingly cases have been reported in the literature among apparently healthy individuals. Dental surgery, contaminated intravenous fluids, enteric fever, gastroenteritis and intravesicular injections of M.bovis or Bacillus Calmette Guerin for bladder carcinoma have been reported as risk factors in the immunocompetent subjects. 3-5The common causative organisms include Staphylococcus aureus and Streptococcus pneumonia. Although cases of Pseudomonas and Klebsiella endophthalmitis have been reported among immunocompetent subjects. 6,7 Common fungal isolates are Candida and Aspergillus. 4 We report a case of endogenous endophthalmitis in an immunocompetent subject after intravenous fluid therapy for gastroenteritis. Case ReportA twenty eight year old female presented with rapidly progressive loss of vision in the left eye for one week associated with mild pain. She was apparently healthy with no history suggestive of any autoimmune disease, immunosuppression or chronic systemic illness. There was no history of anorexia, weight loss, nausea, headache, fever, hearing loss, skin wounds, ulcers of mouth or genitalia, ocular trauma or previous ocular surgery. History of intravenous drug abuse and other risk taking behaviour were also excluded. One week prior to onset of symptoms, the patient developed an attack of acute gastroenteritis for which she was given intravenous dextrose normal saline (DNS) by some health care professional in rural settings. She was relieved of the gastrointestinal symptoms but developed diminution of vision in the left eye two days after intravenous fluid infusion. On examination her visual acuity in right eye was 6/6 and in left eye was hand moments only. Slit lamp examination of left eye revealed mild flare and 2+ cells in anterior chamber. Fundus examination showed the presence of vitreous exudates extending to posterior pole near macula. Subretinal abscess occupying the posterior pole was also present (Figure 1a & b). Ocular exam...

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Fungal Endophthalmitis After a Single Intravenous Administration of Presumably Contaminated Dextrose Infusion Fluid

Abstract: Failures of pneumatic retinopexy were related to lens status, localization of the break, and cryopexy. The occurrence of early and late complications was similar to that in other procedures.

Cited by 48 publications

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Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center

Retrospective analysis of etiopathogenesis of all cases of endophthalmitis at a large tertiary referral center

Endogenous mycotic endophthalmitis in an immunocompetent patient

Contaminated Dextrose Normal Saline: A Cause of Endogenous Endophthalmitis in an Immunocompetent Subject

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