trimethoprim--sulfamethoxazole-drug-combination and Endophthalmitis

Topics: Abscess; Acute Disease; Anti-Bacterial Agents; Clindamycin; Dental Care; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Female; Humans; Intravitreal Injections; Iris Diseases; Middle Aged; Streptococcal Infections; Streptococcus intermedius; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin

Topics: Aged, 80 and over; Anti-Infective Agents; Endophthalmitis; Eye Infections, Bacterial; Humans; Male; Nocardia; Nocardia Infections; Tomography, X-Ray Computed; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity; Vitreous Body

Topics: Aged; Anti-Bacterial Agents; Bacteremia; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Humans; Male; Meropenem; Nocardia; Nocardia Infections; RNA, Bacterial; RNA, Ribosomal, 16S; Thienamycins; Trimethoprim, Sulfamethoxazole Drug Combination

The authors investigate clinical settings, antibiotic susceptibility and resistance patterns, and visual outcomes associated with endophthalmitis caused by Stenotrophomonas maltophilia.. Records of six patients with S. maltophilia endophthalmitis between January 1, 1998, and December 31, 2007, were reviewed.. Clinical settings included post-trauma (2 eyes), post-cataract extraction (2 eyes), post-keratoplasty with keratitis (1 eye), and post-vitreous lavage (1 eye). Presenting visual acuity ranged from counting fingers to no light perception. Final visual acuity ranged from 10/20 to no light perception. Initial treatment included pars plana vitrectomy in 4 eyes and tap in 2 eyes. Most isolates were susceptible to fluoroquinolones (ciprofloxacin, levofloxacin, or moxifloxacin) and sulfamethoxazole-trimethoprim; however, they were resistant to ceftazidime and aminoglycosides.. S. maltophilia is an uncommon causative agent of endophthalmitis and is resistant to commonly used antibiotics, such as ceftazidime and aminoglycosides. Based on in vitro antibiotic susceptibility testing, sulfamethoxazole-trimethoprim and new-generation fluoroquinolones may be preferable in the treatment of endophthalmitis caused by S. maltophilia.

Topics: Adult; Aged; Child, Preschool; Drug Resistance, Bacterial; Endophthalmitis; Eye Infections, Bacterial; Eye Injuries, Penetrating; Female; Fluoroquinolones; Gram-Negative Bacterial Infections; Humans; Male; Microbial Sensitivity Tests; Phacoemulsification; Stenotrophomonas maltophilia; Surgical Wound Infection; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity; Wounds, Nonpenetrating

Topics: Anti-Bacterial Agents; Endophthalmitis; Eye Infections, Bacterial; Humans; Immunocompetence; Male; Middle Aged; Nocardia Infections; Trimethoprim, Sulfamethoxazole Drug Combination

A case is presented of bilateral intraocular nocardial infection associated with lung and liver foci and responding to treatment. Difficulties in diagnosis and treatment are discussed. It is suggested that unusual infections such as this should be considered in the differential diagnosis of chorioretinitis, and should be carefully sought, especially in immunocompromised patients. However, our patient is unusual in having no evidence of immunosuppression predisposing to ocular involvement in his nocardial infection.

Topics: Biopsy; Chorioretinitis; Diagnosis, Differential; Endophthalmitis; Humans; Liver Diseases; Lung Diseases; Male; Middle Aged; Nocardia Infections; Radiography; Sulfamethazine; Trimethoprim, Sulfamethoxazole Drug Combination; Ultrasonography; Visual Acuity