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Streptococcus pneumoniae endophthalmitis: clinical settings, antibiotic susceptibility, and visual outcomes
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Streptococcus pneumoniae endophthalmitis: clinical settings, antibiotic susceptibility, and visual outcomes
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Journal Article
Streptococcus pneumoniae endophthalmitis: clinical settings, antibiotic susceptibility, and visual outcomes
2021
Overview
Streptococcus pneumoniae
endophthalmitis is clinically more severe, more difficult to treat, and carry a higher risk of vision loss, evisceration, or enucleation. This study is to investigate the clinical settings, antibiotic susceptibility, and visual outcomes of
S. pneumoniae
endophthalmitis at a tertiary referral center in Taiwan
. S. pneumoniae
endophthalmitis was diagnosed in 38 eyes of 38 patients. The main clinical features were postcataract endophthalmitis (n = 13, 34%) and endophthalmitis associated with corneal ulcer (n = 12, 32%), trauma (n = 6, 16%), endogenous etiology (n = 4, 11%), trabeculectomy (n = 2, 5%), and pterygium excision-related scleral ulcer (n = 1, 3%). Presenting visual acuity ranged from counting fingers to no light perception. Pars plana vitrectomy with intravitreal antibiotics was performed in 17 eyes (39%) in primary or secondary treatments.
S. pneumoniae
isolates were susceptible to vancomycin (38/38, 100%), penicillin (37/38, 97%), ceftriaxone (37/38, 97%), cefuroxime (12/15, 80%), levofloxacin (13/15 ,87%), and moxifloxacin (15/17, 88%). Final visual acuity was better than 20/400 in 3 of 38 eyes (8%), 5/200 to hand motions in 3 eyes (8%), and light perception to no light perception in 32 eyes (84%). Ten eyes (26%) underwent evisceration or enucleation. Although
S. pneumoniae
isolates were susceptible to vancomycin,
S. pneumoniae
endophthalmitis had a very poor visual prognosis.
