RESUMO
The case is presented of a 62 year-old woman with a rapid, progressive bilateral decrease in visual acuity and panuveitis with orbital cellulitis. She was also in poor general condition, with emesis and fever. Septicaemia due to Klebsiella pneumoniae and bilateral endogenous panophthalmitis were diagnosed. The ocular infection quickly progressed to sclerokeratitis and bilateral perforation despite broad spectrum systemic antibiotic management, and eventually the patient required bilateral enucleation. Microbiological cultures of the surgical pieces identified Klebsiella pneumoniae and Candida magnoliae. To our knowledge, this is the third published case that required bilateral enucleation or evisceration due to endogenous panophthalmitis, and the first case of endogenous ocular infection caused by Candida magnoliae.
Assuntos
Candidíase/cirurgia , Enucleação Ocular , Infecções por Klebsiella/cirurgia , Klebsiella pneumoniae/isolamento & purificação , Panoftalmite/cirurgia , Antibacterianos/uso terapêutico , Candidíase/microbiologia , Coinfecção/cirurgia , Terapia Combinada , Perfuração da Córnea/etiologia , Progressão da Doença , Feminino , Humanos , Infecções por Klebsiella/microbiologia , Pessoa de Meia-Idade , Celulite Orbitária/tratamento farmacológico , Celulite Orbitária/cirurgia , Panoftalmite/tratamento farmacológicoRESUMO
Here we report a case of childhood glaucoma refractory to angle and trabeculectomy surgery. The patient was treated with an Ahmed™ drainage implant that was subsequently complicated by rapid-onset panophthalmitis and orbital cellulitis. Intravenous and intravitreal antibiotic therapy was initiated and the drainage tube was removed. The infectious process resolved within 3 weeks; however, phthisis bulbi developed subsequently.
Assuntos
Implantes para Drenagem de Glaucoma/efeitos adversos , Glaucoma/cirurgia , Celulite Orbitária/etiologia , Panoftalmite/etiologia , Antibacterianos/uso terapêutico , Remoção de Dispositivo , Glaucoma/congênito , Humanos , Lactente , Pressão Intraocular , Masculino , Celulite Orbitária/tratamento farmacológico , Panoftalmite/tratamento farmacológico , Complicações Pós-Operatórias , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus epidermidis/isolamento & purificação , Resultado do TratamentoRESUMO
ABSTRACT Here we report a case of childhood glaucoma refractory to angle and trabeculectomy surgery. The patient was treated with an Ahmed™ drainage implant that was subsequently complicated by rapid-onset panophthalmitis and orbital cellulitis. Intravenous and intravitreal antibiotic therapy was initiated and the drainage tube was removed. The infectious process resolved within 3 weeks; however, phthisis bulbi developed subsequently.
RESUMO Relato de um caso de uma criança portadora de glaucoma congênito primário, refratário a cirurgias angulares e trabeculectomias prévias, submetido à implante de drenagem do tipo Ahmed®. O paciente evoluiu com panoftalmite e celulite orbitária de aparecimento súbito, sendo submetido à remoção do tubo e antibioticoterapia endovenosa e intravítrea. O processo infeccioso foi resolvido em três semanas, porém o olho evoluiu para phthisis bulbi.