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At least 19 recordsLinked to original sources
PubMed2004

Case report of tuberculous panophthalmitis.

BACKGROUND: Although tuberculosis is very common in the Indian sub-continent, tuberculous panophthalmitis has not been reported from this region so far. We report a case of a young girl with tuberculous panophthalmitis. CASE REPORT: A 12-year-old female child presented with painless progressive loss of vision in the right eye of two months' duration. Examination revealed diffuse corneal haze with deep vascularization, iris nodules, and scleral necrosis. Histopathological examination of the enucleated eye revealed necrotizing granulomatous inflammation, multiple epitheloid cell granulomas, and Langhan's giant cells, along with large areas of caseous necrosis. Chest X-ray revealed right hilar lymphadenopathy with right lower zone infiltration and a small pleural effusion. Considering the clinical picture, histopathology and chest findings, a diagnosis of disseminated tuberculosis was made, and standard four-drug anti tubercular treatment was started. At 2 months follow up there was radiological resolution of the lung lesions and pleural effusion. CONCLUSIONS: Clinical features suggestive of tubercular panophthalmitis are absence of pain, presence of nodules on or within the eyeball, and spontaneous perforation. We would like to emphasize that in all susceptible individuals presenting with clinical suspicion of ocular tuberculosis it would be prudent to start early anti-tubercular therapy to prevent progression to panophthalmitis. A complete systemic workup to look for any other possible focus of tubercular involvement must be done.

Child↗
PubMed1998

[Panophthalmitis and results of HIV tests. Experience at the Cocody University Hospital Center in Abidjan, Ivory Coast].

PURPOSE: We assessed the frequency of panophthalmitis in HIV-infected patients. MATERIALS AND METHODS: Thirty-seven cases of panophthalmitis were screened out of 420 hospitalized patients of ophthalmology department of Cocody Teaching University Hospital, Abidjan, Ivory Coast, from January to October 1995. HIV-tests were performed in 11 patients. RESULTS: Mean age was 40 years (from 10 months to 75 years). Four patients (36.4% of tested patients) were infected by HIV. Contrary to seronegative patients, panophthalmitis cases in HIV-infected patients occurred spontaneously without any apparent exogenous cause (foreign bodies). Most of patients were young (from 18 to 47 years old). CONCLUSION: We draw the attention of eye specialists of the frequency of panophthalmitis without exogenous apparent cause in HIV patients. It would be interesting to perform a transvitreal needle biopsy in order to search for intraocular toxoplasmosis that should be the first cause.

AIDS Serodiagnosis↗
PubMed2004

Panophthalmitis due to clostridium septicum.

PURPOSE: To describe patient survival in a rare case of endogenous Clostridium septicum sepsis with panophthalmitis. DESIGN: Observational case report. METHODS: Both eyes of a female patient were examined in a hospital setting. RESULTS: A 68-year-old woman had right orbital pain, proptosis, panophthalmitis, mental confusion and fever for 2 days. Blood cultures were significant for Clostridium septicum. The patient did not improve after treatment with intravenous broad-spectrum antibiotics and the right eye was enucleated. The patient survived the acute infection and extensive systemic evaluation revealed an undiagnosed colon carcinoma that may have been responsible for colonization and vascular dissemination of Clostridium septicum. CONCLUSIONS: Clostridium septicum panophthalmitis and sepsis can be the presenting sign in patients with unsuspected malignancies, particularly colon cancer. Patients can survive the infection with aggressive therapy with systemic antibiotics combined with removal of the infected tissue.

Acute Disease↗
PubMed2004

Orbital cellulitis, panophthalmitis, and ecthyma gangrenosum in an immunocompromised host with pseudomonas septicemia.

PURPOSE: To describe a case of Pseudomonas aeruginosa septicemia complicated by orbital cellulitis, panophthalmitis, and ecthyma gangrenosum. DESIGN: Observational case report. METHODS: An immunosuppressed 62-year-old man developed an unusual skin rash and a painful, swollen right eye with decreased vision. He had myelodysplastic syndrome and P. aeruginosa septicemia. The skin rash manifested as ecthyma gangrenosum. Metastatic orbital cellulitis and panophthalmitis was diagnosed. RESULTS: Despite intravitreal and topical gentamicin, the patient eventually required enucleation. CONCLUSIONS: This case represents a rare combination of events: an immunocompromised man developed pneumonia, P. aeruginosa septicemia, and endogenous seeding of the Pseudomonas to the skin, orbit, and eye. Early recognition of endogenous ophthalmic disease is imperative. The prognosis of combined orbital cellulitis and panophthalmitis is poor.

Bacteremia↗
PubMed1994

Clostridium bifermentans panophthalmitis after penetrating eye injury.

BACKGROUND: Intraocular and orbital anaerobic infections usually result from penetrating eye injuries with soil-contaminated foreign bodies. The outcome of these infections almost always has been loss of the globe, despite appropriate antibiotic and surgical treatment. The most prevalent etiologic microbe of anaerobic panophthalmitis is Clostridium perfringens. CASE REPORT: To the authors' knowledge, this is the first report of panophthalmitis caused by Clostridium bifermentans after penetrating eye injury. The patient had severe signs and symptoms of intraocular and orbital infection, with early total loss of visual function. Parenteral and intravitreal therapy with penicillin and clindamycin, administered according to antibiotic sensitivity studies of cultures from the anterior chamber and vitreous, did not restore vision. CONCLUSIONS: Due to the early devastating outcome, penetrating eye injuries with soil-contaminated foreign bodies should be regarded as being at high risk for clostridial infection and should be treated promptly with vitrectomy and antibiotic therapy for aerobic and anaerobic infection.

Adolescent↗
PubMedDate not supplied

Bacillus cereus panophthalmitis: source of the organism.

Serious infections with the "nonpathogenic" Bacillus species are increasingly being recognized, especially in drug abusers. Cases of panophthalmitis secondary to infection with Bacillus cereus, with and without associated bacteremia, have been reported. Three drug abusers with panophthalmitis seen in our hospitals during a three-year period are described, and the similar cases reported in the literature are reviewed. The syndrome is characterized by an acute onset with a rapid fulminating course that eventually leads to enucleation or evisceration of the eye. The pathogenic mechanism is unknown, but is probably related to the production of toxin (lecithinase) by B. cereus. Clindamycin appears to be the antibiotic of choice in the treatment of this infection. In order to identify a possible source of the organism, 59 samples of heroin and injection paraphernalia were cultured. Twenty cultures yielded organisms; Bacillus species were the predominant isolates. Thirty-eight percent of the isolates were identified as B. cereus. Thus, infections caused by Bacillus species in drug abusers can probably be associated with intravenous heroin abuse because heroin mixtures and injection paraphernalia are frequently contaminated with this organism.

Adult↗
PubMed2005

Enucleation with primary implant insertion for treatment of recalcitrant endophthalmitis and panophthalmitis.

PURPOSE: A prevalent conception exists that a two-stage operation (i.e., primary enucleation or evisceration with delayed secondary orbital implant insertion) is necessary when enucleation is required for recalcitrant endophthalmitis or panophthalmitis. The purpose of this study was to assess the utility of single-stage enucleation and primary reconstruction in this setting. METHODS: In a retrospective interventional case series, 22 consecutive patients with advanced endophthalmitis or panophthalmitis refractory to prior medical treatment underwent enucleation and primary implant placement by a single surgeon between 1991 and 2001. Eleven patients received hydroxyapatite implants; 11 patients received silicone implants. All patients were treated during surgery with intravenous antibiotics. All patients were evaluated for persistent local or systemic infection, implant exposure, extrusion, and successful fitting of their prostheses. RESULTS: No cases of persistent orbital cellulitis or meningitis occurred in any of the patients. Two patients with silicone orbital implants had extrusions; one was successfully managed with a secondary dermis-fat graft, and another patient who refused additional treatment was allowed to heal by secondary intention after the implant was removed. None of the patients with hydroxyapatite orbital implants had complications. All patients (20/20) who elected to undergo prosthetic fitting were successfully fit with prostheses. One patient elected not to pursue prosthetic fitting. One patient died of unrelated causes before a prosthesis could be fit. There were no objective findings to preclude successful fitting in either case. CONCLUSIONS: This study suggests that enucleation with primary orbital reconstruction and implant insertion for recalcitrant, fulminant ocular infection is an acceptable and advantageous treatment strategy. The risks and expenses associated with two separate surgeries are decreased, hospitalization time is potentially reduced, and subsequent rehabilitation can be initiated in a more timely fashion.

Adult↗
PubMed1994

Gas gangrene panophthalmitis. A case from Greenland.

A case of clostridium perfringens gas gangrene panophthalmitis developed after a penetrating eye injury. The affected eye became amaurotic, but the panophthalmitis was controlled by minimal surgical debridement and systemic antibiotic therapy with penicillin, fucidic acid and metronidazole. Elective enucleation was performed 15 days after the trauma for cosmetic reasons. The enucleated eye was examined histopathologically and showed massive retinal necrosis but no signs of bacteriae.

Anterior Chamber↗
PubMed1990

[A case of sepsis caused by Edwardsiella tarda complicated panophthalmitis and pyogenic spondylitis].

Edwardsiella tarda (E. tarda) is gram negative enterobacteriaceae which has been found generally in animal hosts and occasionally in human feces. We have reported a case of sepsis caused by E. tarda, complicated panophthalmitis and pyogenic spondylitis. A 39-year old patient suffered from fever, polyarthralgia and lumbago. We performed blood culture, from which E. tarda was isolated. Spinal CT scan showed destruction and osteogenesis of the fourth and fifth lumbar vertebral body and cranial CT scan showed destruction of the right lens. So we diagnosed sepsis with pyogenic spondylitis and panophthalmitis. We suspected that chronic ethanol administration reduced the resistance to infection of E. tarda which caused sepsis.

Adult↗
PubMed1982

Fulminating panophthalmitis due to exogenous infection with Bacillus cereus: report of 4 cases.

Bacillus cereus is a seldom recognised but important cause of panophthalmitis. Although most reported cases have been the result of endogenous infection, we have recently seen 4 cases that followed ocular trauma. In each instance a fulminating panophthalmitis developed, accompanied by fever and leucocytosis. Despite prompt therapy all eyes were rapidly lost. In view of the selective antibiotic sensitivities of this organism and the fulminating course of the disease, conventional approaches to therapy, including standard prophylactic antibiotic regimens, are unlikely to be successful in such cases. Analysis of our cases suggest that ocular infection with B. cereus has certain features that may allow a provisional diagnosis to be made before isolation of the organism. Early recognition and prompt institution of effective therapy may lead to salvage of these eyes in the feature.

Adult↗
PubMed1976

[Gas gangrene panophthalmitis (author's transl)].

Gas gangrene panophthalmitis is a rare condition of penetrating injury to the globe. The infecting organism is usually Clostridium perfringens. Characteristic symptoms are a brawny swelling of the lids, marked chemosis, coffee-coloured discharge, hypopyon, ring abscess of the cornea, formation of gas bubbles in the anterior chamber, rise of intraocular tension and early amaurosis. Treatment consists in the evisceration or enucleation of the globe, rarely in the exenteration of the orbit. Antibiotics along (Penicillin, Tetracyclines) are insufficient. Administration of antiserum is almost completely abandoned, it is probably more dangerous than helpful. The use of hyperbaric oxygen is not indicated in cases of gas gangrene panophthalmitis. Extraocular extension of the infection and its danger for the individual is prevented by well-times surgical procedure.

Adult↗
PubMed1979

Bacillus cereus endogenous panophthalmitis.

A case of severe suppurative endogenous panophthalmitis caused by Bacillus cereus resulted from intravenously administered medications. This is the first, to our knowledge, well-documented case of endogenous endophthalmitis associated with this organism. It is recommended that if on Gram's stain of the anterior chamber fluid, Gram-positive rods are seen, chloramphenicol should be administered in addition to penicillin because of the possibility of B cereus infection.

Adult↗
PubMed1985

The failure of cyclosporin to inhibit granulomatous inflammation in acute Arthus-like panophthalmitis.

Acute Arthus-like panophthalmitis (AP) was induced in Lewis rat eyes by lens injury after immunization with whole rabbit lens extract. AP consists of an acute anterior ocular inflammation, followed by a posterior choroidal granulomatous reaction. Neither inflammatory response was inhibited by daily treatment with cyclosporin, 10 mg/kg, beginning on the day of lens injury. Cyclosporin would not be expected to interfere with the lens-induced anterior Arthus-like inflammation. The lack of inhibition of the choroidal inflammation was unexpected. The results are interpreted to indicate that the posterior granulomatous choroidal inflammation is a non-immune reaction initiated by the severe lens-induced Arthus-like reaction.

Animals↗
PubMed1996

Postmortem diagnosis of Fusarium panophthalmitis by the polymerase chain reaction.

PURPOSE: We undertook this study to determine if a polymerase chain reaction-based test that we developed for the filamentary fungus, Fusarium, could be used to detect the organism in postmortem ocular tissues. METHODS: We applied the polymerase chain reaction to amplify a target fragment of Fusarium DNA from formalin-fixed ocular tissues from a patient with endogenous Fusarium panophthalmitis. RESULTS: By using the polymerase chain reaction-based test, we were able to amplify the target fragment of DNA from the infected eyes, but not from uninfected control eyes. CONCLUSIONS: The technique appears to hold promise to be a sensitive, specific, and rapid method of diagnosing Fusarium infections.

Blotting, Southern↗
PubMed1987

Endogenous Clostridium panophthalmitis.

Acute visual loss, pain, and redness in the left eye developed in a 61-year-old diabetic man. Results of ophthalmologic examination showed 4+ conjunctival hyperemia and chemosis, no light perception, and restricted ocular motility. Through a hazy cornea, a gas bubble was visualized filling about 50% of the anterior chamber. A vitreous tap disclosed myriad gram-positive rods with terminal and subterminal spores. Cultures of the vitreous grew Clostridium septicum, a gas-forming organism. Exploratory abdominal laparotomy showed a ruptured diverticulum of the sigmoid colon with acute peritonitis. In spite of intensive antibiotic therapy, the patient died approximately 24 hours after admission. Results of histopathologic examination of the postmortem left eye demonstrated massive necrosis of the intraocular structures with numerous gram-positive rods confined mainly to the retinal pigment epithelium (RPE), detached retina, and vitreous. To the best of the authors' knowledge, this is the second reported case of C. septicum panophthalmitis. Only 69 cases of clostridial infections with ocular involvement have been recorded previously in the literature.

Clostridium Infections↗
PubMed2006

Severe Candida albicans panophthalmitis treated with all available and potentially effective antifungal drugs: fluconazole, liposomal amphotericin B, caspofungin, and voriconazole.

A severe case of Candida albicans panophthalmitis, probably prompted by an underlying diabetes mellitus, is reported. The course was prolonged (more than 16 weeks), although favourable after treatment with several antifungal agents, all with a predictable activity in this ocular complication and with proven susceptibility in the present case: fluconazole, liposomal amphotericin B, caspofungin, and voriconazole.

Amphotericin B↗
PubMed1983

Histopathology in botryomycosis-like panophthalmitis due to Staphylococcus aureus. A light microscopic and electron microscopic study. A case report.

A Swedish farmer's wife aged 46 developed a unilateral panophthalmitis 6 weeks after a visit to Gambia in Africa. Vitreous puncture revealed growth of Staphylococcus aureus, but in spite of adequate treatment the eye had to be enucleated 5 weeks after the onset of symptoms. Gram-positive microorganisms in botryomycosis-like granules in the vitreal abscesses were at first suspected to be Histoplasma capsulatum. Electron microscopic examination revealed microorganisms, consistent with staphylococci. There was extensive proliferation of mesosomes, most probably due to the intense treatment. The poor nutrition and slow resorption of the dead microorganisms from the avascular vitreous did possibly also play a part in the proliferation of the mesosomes.

Anti-Bacterial Agents↗
PubMed1982

Panophthalmitis caused by Vibrio parahaemolyticus.

We report a case of Vibrio parahaemolyticus panophthalmitis which resulted from contamination of a wound with water from a pond in inland Georgia. The pond was on the property of an oil refinery which receives crude oil from southern Mississippi. Cultures of the pond water 5 years later did not yield V. parahaemolyticus, but did yield non-O1 V. cholerae and had 0.28% sodium chloride content. V. parahaemolyticus may have been introduced into the pond along with oil transported from the Gulf of Mexico, and growth of this halophilic species may have been supported by salt from spilled crude oil.

Accidents, Occupational↗