Endogenous Bacterial Endophthalmitis: A Five-Year Retrospective Review at a Tertiary Care Academic Center

Ocul Immunol Inflamm. 2020 Aug 17;28(6):975-983. doi: 10.1080/09273948.2019.1642497. Epub 2019 Aug 16.

Abstract

Purpose: To better characterize the demographics and outcomes of endogenous bacterial endophthalmitis (EBE).

Methods: Retrospective observational case series of 49 eyes of 41 patients with EBE evaluated at a single academic center.

Results: Gram stain (p = .395), symptom duration prior to treatment (p = .483), and number of intravitreal antimicrobial injections (p = .421) did not correlate with mean change in VA. There was no significant difference between mean LogMAR VA at initial evaluation (1.7 ± 0.9) and last available follow up (1.4 ± 1.1, p = .15). Patients with bilateral EBE had 7.25 times greater odds of having cancer (95% CI 1.28, 41.14; p = .025).

Conclusion: EBE in a North American population showed poor visual recovery despite treatment. It was most commonly due to gram-positive bacteria with the most common infectious source being endocarditis. Malignancy should be considered in patients with bilateral EBE.

Keywords: Endogenous; North America; bacterial endophthalmitis; endogenous bacterial endophthalmitis; endophthalmitis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endophthalmitis / drug therapy
  • Endophthalmitis / epidemiology*
  • Endophthalmitis / microbiology
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / epidemiology*
  • Eye Infections, Bacterial / microbiology
  • Female
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers / statistics & numerical data
  • Visual Acuity / physiology