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The most common causes of bacterial endophthalmitis are ocular surgery, usually cataract extraction, and endogenous spread from other infections such as meningitis, abdominal infection, endocarditis, and urinary tract infection.1 The clinical course is highly variable and depends on the virulence of the infecting organism, the quickness of diagnosis and administration of antibiotics, and the patient's underlying medical condition. According to the Endophthalmitis Vitrectomy Study2 conducted between 1990 and 1994, which studied the role of immediate vitrectomy and of intravenous antibiotics in the management of postoperative bacterial endophthalmitis, on post hoc data analysis, there was no difference in visual outcome whether or not an immediate vitrectomy was performed, except in a selected subgroup of patients. Furthermore, no ocular benefit was derived from the administration of systemic antibiotics. We reviewed the medical record of a patient who developed meningitis following a postoperative case of Streptococcus pneumoniae endophthalmitis. Since the advent of antibiotics, no other cases have been reported of systemic spread from a primary exogenous bacterial endophthalmitis, to our knowledge.
Chan SM, Hodge WG, Leonard BC. Postoperative Streptococcus pneumoniae Endophthalmitis Complicated by Meningitis. Arch Ophthalmol. 1998;116(7):951–953. doi:
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