Endophthalmiti caued by treptococcu pneumoniae

Purpoe To invetigate clinical etting, management trategie, antibiotic enitivitie, and viual acuity outcome of endophthalmiti caued by treptococcu pneumoniae. Deign Retropective, obervational cae erie. Method Record were reviewed of all patient with culture-poitive endophthalmiti caued by treptococcu pneumoniae treated at the Bacom Palmer Eye Intitute between January 1, 1989 and December 31, 2003. MAIN OUTCOME MEAURE: Viual acuity and antibiotic enitivitie. Reult Twenty-even eye of 27 patient met tudy incluion criteria. The median follow-up wa 7 month (range, 3 month to 10 year). Clinical etting included acute potoperative (10 eye), corneal titch abce (5), corneal ulcer (3), bleb-aociated (4), pot-trauma (3), and endogenou (2). Eighteen cae (67%) were acute-onet (le than 3 week from event), with a median interval between event and preentation of endophthalmiti of 5 day (range, 1 day to 16 day). Nine cae (33%) were delayed-onet (median, 27 month; range, 3 to 121 month). Initial viual acuity wa hand motion or better in 11 cae (41%). Initial therapeutic procedure included vitreou tap and injection of intravitreal antibiotic in 15 eye (56%), par plana vitrectomy and injection of intravitreal antibiotic in 10 eye (37%), and eviceration in 2 eye (7%). eventeen (68%) of 25 eye received intravitreal dexamethaone. Twelve patient (48%) received additional doe of intraocular antibiotic, and 11patient (44%) underwent econdary urgical intervention within one week of diagnoi. The treptococcu pneumoniae iolate howed enitivity pattern a follow: 27/27 vancomycin, 13/13 clindamycin, 6/6 cefazolin, 11/11 ciprofloxacin, 14/14 moxifloxacin, 24/26 (92%) ofloxacin, 12/14 (86%) levofloxacin, 13/14 (93%) gatifloxacin, and 1/13 (8%) gentamicin. The organim wa enitive to at leat one antibiotic adminitered initially in all cae. Final viual acuity wa 20/400 or better in 8/27 (30%) cae, but 10 eye (37%) had a final viion of no light perception. Concluion Depite prompt treatment with appropriate antibiotic, endophthalmiti caued by treptococcu pneumoniae i aociated with a poor viual prognoi.