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Journal of Clinical Microbiology, January 1998, p. 48-51, Vol. 36, No. 1
Moorfields Eye Hospital,
Received 5 June 1997/Returned for modification 17 July
1997/Accepted 9 October 1997
Members of the genus Enterobacter are commensal
organisms of the gastrointestinal tract and are considered pathogenic
only for patients with lowered resistance to infection (e.g., chronic infection, cancer, or diabetes mellitus) or those with impaired immunity (congenital, acquired, or impaired immunity secondary to
therapy). We report on four cases of endophthalmitis caused by
Enterobacter cloacae: two in patients with acute
postoperative endophthalmitis, one in a patient with delayed
bleb-related endophthalmitis, and one in a patient presenting with
presumed posttraumatic endophthalmitis. Each patient presented with
severe disease many days after the onset of ocular symptoms, and two
patients had systemic risk factors accounting for a reduced resistance
to infection. Endophthalmitis caused by gram-negative bacilli is
characterized by acute onset, rapid progression, and poor final visual
outcome. Each of these patients was treated by a standard protocol with
intravitreal, systemic, and topical antibiotics and systemic steroids.
Despite treatment, the final visual outcomes for three of these
patients was no perception of light, and that for one patient remained perception of hand movements only. In common with endophthalmitis caused by other gram-negative organisms, intraocular infection secondary to Enterobacter cloacae infection is a
devastating disease which, despite treatment, results in extensive
ocular damage and severe visual loss. Since 1966, only four cases of
endophthalmitis secondary to infection with members of this genus have
been reported. This report presents four cases which occurred over a
period of 14 months and, to the best of our knowledge, the first case
of bleb-related endophthalmitis secondary to E. cloacae
infection.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Enterobacter cloacae Endophthalmitis:
Report of Four Cases
*
Corresponding author. Mailing address: Department of
Clinical Ophthalmology, The Institute of Ophthalmology, 11-43 Bath
St., London EC1V 9EL, United Kingdom. Phone: 0171-608-6872. Fax:
0171-608-6931. E-mail:
nokhravi{at}menu.hgmp.mrc.ac.uk. [Reprint requests
to S. Lightman, Department of Clinical Ophthalmology, Moorfields Eye Hospital, City Road, London EC1V 2PD, United Kingdom. Phone:
0171-253-3411, extension 2266. Fax: 0171-566-2456.]
Journal of Clinical Microbiology, January 1998, p. 48-51, Vol. 36, No. 1
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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