Ovadendron sulphureo-ochraceum Endophthalmitis After Cataract Surgery
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia. American Journal of Ophthalmology
(Impact Factor: 3.87).
04/1995; 119(3):307-12. DOI: 10.1016/S0002-9394(14)71172-9
We examined an 82-year-old woman with delayed-onset endophthalmitis caused by an opportunistic pathogen, Ovadendron sulphureo-ochraceum.
Tissue obtained during vitrectomy was cultured and examined by light and electron microscopy. An enucleation specimen was examined by light microscopy.
The patient had fungal endophthalmitis, with O. sulphureo-ochraceum present in the lens capsule. The eye developed a necrotizing scleritis secondary to O. sulphureo-ochraceum. The patient failed to respond to intravitreous, subconjunctival, and systemic amphotericin B, and the eye was enucleated.
In this case of O. sulphureo-ochraceum as a human pathogen, the organism caused endophthalmitis after cataract extraction.
Available from: Lily Novak Frazer
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ABSTRACT: A 50-year-old diabetic man developed necrotizing scleritis with adjacent keratitis 4 weeks after uncomplicated cataract extraction and intraocular lens implantation through a scleral tunnel incision. Cultures of the necrotic sclera grew Rizopus species. Severe destruction of the globe ensued despite topical, subconjunctival, and intravenous amphotericin B, in combination with hyperbaric oxygen therapy. Histopathological examination of the enucleated globe was consistent with Rhizopus infection. One year later, the patient was well without signs of recurrence.
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ABSTRACT: By a clinicopathologic study, to evaluate the histopathologic features associated with various causes of scleritis.
Retrospective observational case series.
Enucleated globes or biopsy specimens obtained from 55 cases of clinically diagnosed necrotizing scleritis.
On the basis of their histologic appearance, these cases were divided into four morphologic groups: (1) zonal necrotizing granulomatous scleral inflammation; (2) nonzonal diffuse scleral inflammation, with or without granulomatous process; (3) necrotizing inflammation with microabscesses, with or without evidence of micro-organisms in the section studied; and (4) sarcoidal granulomatous inflammation. The clinical charts were reviewed for the presence of any associated disease.
There were 14 (25.4%) cases in the first group; 12 had clinical evidence of systemic autoimmune diseases, including 8 cases of rheumatoid arthritis and 1 each of polychondritis, Goodpasture syndrome, Wegener granulomatosis, and collagen vascular disease; of the remaining 2 cases, 1 patient had a history of herpes zoster ophthalmicus, and the other had no history of any systemic autoimmune or infectious disease. None of the 19 (34.5%) patients characteristic of group 2 had any history of systemic autoimmune or infectious disease. Eleven of the 21 (38.2%) patients in group 3 had infections, including Pseudomonas spp., gram-positive cocci, Haemophilus spp., Actinomyces spp., and fungi; in the 10 remaining cases, no micro-organisms could be detected. The one case in group 4 was diagnosed as sarcoidosis.
On the basis of their histologic features, rheumatoid scleritis and related systemic autoimmune-mediated necrotizing scleral inflammations could be differentiated from either idiopathic or infectious scleritis; however, the histologic features of rheumatoid scleritis were similar to those of necrotizing scleritis associated with other systemic autoimmune diseases.
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