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August 1979

Endophthalmitis After Staphylococcal Sepsis

Author Affiliations

San Francisco

Arch Intern Med. 1979;139(8):942-943. doi:10.1001/archinte.1979.03630450084029

To the Editor.—  Dr Bloomfield and his coauthors are to be complimented for their recent publication in the Archives (138:706-708, 1978) describing two patients with chronic renal failure receiving maintenance hemodialysis in whom endophthalmitis developed several months after proven staphylococcal sepsis. However, one must be somewhat skeptical about their presumptive causative diagnosis of "metastatic staphylococcal" endophthalmitis that was based on (1) a history of positive blood cultures for Staphylococcus aureus three months previously, (2) the lack of definite evidence for another causative organism, and (3) the patients' response to antibacterial and steroid therapy. After reading the published data, it is difficult to fully agree with their conclusions, and several aspects of the report are worthy of further comment.First, only one of these two patients underwent a diagnostic anterior chamber paracentesis, and although the authors are correct in stating that the negative culture of this aspirate does not rule out