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Case Reports
Journal Article
Clinical Features and Management of Subretinal Abscesses Secondary to Methicillin-Resistant Staphylococcus aureus Endogenous Endophthalmitis.
Ophthalmic Surgery, Lasers & Imaging Retina 2017 Februrary 2
BACKGROUND AND OBJECTIVE: To describe the clinical features, management, and immediate outcomes of patients with subretinal abscesses secondary to methicillin-resistant Staphylococcus aureus (MRSA) endogenous endophthalmitis.
PATIENTS AND METHODS: Eleven eyes of seven patients were identified by retrospective chart review. Demographics, initial presentation, examination findings, imaging, cultures, treatments, and short-term outcomes were reviewed.
RESULTS: Eleven eyes of seven patients presented with subretinal abscesses secondary to MRSA endogenous endophthalmitis. Four had history of recurrent MRSA infections or active soft-tissue ulceration. Six underwent vitreous tap for culture without growth. Three had positive blood cultures for MRSA. Six received empiric therapy with intravenous vancomycin, one received oral trimethoprim-sulfamethoxazole, and six received intravitreal vancomycin. Consolidation of abscesses was seen within days of initial treatment. Visual outcomes were contingent on abscess location and time to initial treatment.
CONCLUSION: Prompt diagnosis and systemic antibiotic therapy is paramount in the treatment of this rare presentation. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:134-142.].
PATIENTS AND METHODS: Eleven eyes of seven patients were identified by retrospective chart review. Demographics, initial presentation, examination findings, imaging, cultures, treatments, and short-term outcomes were reviewed.
RESULTS: Eleven eyes of seven patients presented with subretinal abscesses secondary to MRSA endogenous endophthalmitis. Four had history of recurrent MRSA infections or active soft-tissue ulceration. Six underwent vitreous tap for culture without growth. Three had positive blood cultures for MRSA. Six received empiric therapy with intravenous vancomycin, one received oral trimethoprim-sulfamethoxazole, and six received intravitreal vancomycin. Consolidation of abscesses was seen within days of initial treatment. Visual outcomes were contingent on abscess location and time to initial treatment.
CONCLUSION: Prompt diagnosis and systemic antibiotic therapy is paramount in the treatment of this rare presentation. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:134-142.].
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