Endophthalmitis caused by Haemophilus influenzae

Daniel M. Yoder, Ingrid U. Scott, Harry W Flynn, Darlene Miller

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

To investigate the clinical settings, management strategies, antibiotic sensitivities, and visual acuity outcomes for eyes with endophthalmitis caused by Haemophilus influenzae. Retrospective, noncomparative, consecutive case series. The medical records were reviewed of all patients treated for culture-proven H. influenzae endophthalmitis at a single institution between January 1, 1980, and December 31, 2002. Visual acuity and antibiotic sensitivities. The study included 16 eyes of 16 patients with a median age of 68 years (range, 6 months-83 years) and a median follow-up of 26 months (range, 2 months-15 years). Clinical settings included post-trabeculectomy (n = 7), post-cataract surgery (n = 6), post-pars plana vitrectomy (n = 1), post-secondary intraocular lens insertion (n = 1), and post-suture removal from an extracapsular cataract wound (n = 1). Eleven (69%) cases were of delayed onset (>6 weeks from surgery/event), with a median interval between surgery/event and presentation with endophthalmitis of 18 months (range, 44 days-21 years); 5 (31%) cases were of acute onset (median, 6 days; range, 2-14 days). Presenting visual acuity was hand movements or better in 7 (44%) eyes. A vitreous tap and inject was performed initially in 9 (56%) eyes, and a vitrectomy was performed initially in the remaining 7 (44%) eyes. All eyes received intravitreal antibiotics on the day of presentation, and 11 (69%) received intravitreal dexamethasone. In vitro testing of the H. influenzae isolates revealed that 14 of 16 (88%) were sensitive to vancomycin, ampicillin, and trimethoprim/sulfamethoxazole; 15 of 16 (94%) were sensitive to aminoglycosides (1 isolate was resistant to gentamicin); and all were sensitive to cephalosporins, fluoroquinolones, and carbapenems. The organisms were sensitive to at least 1 of the initial antibiotics administered in all cases. Final visual acuity was 5/200 or better in 6 (38%) eyes, and 6 (38%) eyes had a final visual acuity of no light perception. Endophthalmitis caused by H. influenzae is generally associated with poor visual outcomes despite prompt treatment with intravitreal antibiotics to which the organisms were sensitive.

Original languageEnglish
Pages (from-to)2023-2026
Number of pages4
JournalOphthalmology
Volume111
Issue number11
DOIs
StatePublished - Nov 1 2004

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Endophthalmitis
Haemophilus influenzae
Visual Acuity
Anti-Bacterial Agents
Vitrectomy
Cataract
Trabeculectomy
Carbapenems
Temazepam
Intraocular Lenses
Fluoroquinolones
Sulfamethoxazole Drug Combination Trimethoprim
Aminoglycosides
Cephalosporins
Vancomycin
Ampicillin
Gentamicins
Dexamethasone
Sutures
Medical Records

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Endophthalmitis caused by Haemophilus influenzae. / Yoder, Daniel M.; Scott, Ingrid U.; Flynn, Harry W; Miller, Darlene.

In: Ophthalmology, Vol. 111, No. 11, 01.11.2004, p. 2023-2026.

Research output: Contribution to journalArticle

Yoder, Daniel M. ; Scott, Ingrid U. ; Flynn, Harry W ; Miller, Darlene. / Endophthalmitis caused by Haemophilus influenzae. In: Ophthalmology. 2004 ; Vol. 111, No. 11. pp. 2023-2026.
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