Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes
Context: Forty-eight pediatric patients treated for endogenous endophthalmitis were analyzed. Redness and vitritis were the common symptom and sign, respectively; infection with Gram-negative bacilli was frequent. Children under 5 and with systemic illness had poorer visual prognosis. Purpose: To An...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-05-01
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| Series: | Indian Journal of Ophthalmology |
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| Online Access: | https://journals.lww.com/10.4103/IJO.IJO_2298_24 |
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| author | Ridham Nanda Taraprasad Das Tapas Ranjan Padhi Krushna Gopal Panda Marina Ger Srikanta Kumar Padhy |
| author_facet | Ridham Nanda Taraprasad Das Tapas Ranjan Padhi Krushna Gopal Panda Marina Ger Srikanta Kumar Padhy |
| author_sort | Ridham Nanda |
| collection | DOAJ |
| description | Context:
Forty-eight pediatric patients treated for endogenous endophthalmitis were analyzed. Redness and vitritis were the common symptom and sign, respectively; infection with Gram-negative bacilli was frequent. Children under 5 and with systemic illness had poorer visual prognosis.
Purpose:
To Analyze the demographics, clinical-microbiological profiles, and treatment outcomes of pediatric patients with endogenous endophthalmitis.
Methods:
We conducted a retrospective analysis of electronic medical records covering 8 years from 2016 to 2023 at a tertiary eye care center in India, focusing on patients of age <18 years diagnosed with endogenous endophthalmitis. Data extraction included demographic variables, clinical presentations, microbiological analyses, therapeutic interventions, and visual outcomes.
Results:
The analysis included 48 patients with an average age of 5.4 ± 4.98 years and an equal gender ratio. During the study period, 48 children with endogenous endophthalmitis were treated; it was 5% (48 of 961) of all endophthalmitis patients and 20.8% (48 of 231) of pediatric endophthalmitis patients. Common symptoms included redness (62.5%), reduced vision (20.8%), leucocoria (27.08%), pain (22.91%), and watering/discharge (29.16%). Clinical signs included vitritis (89.58%) and anterior chamber exudates/hypopyon (47.91%). Vitreous culture positivity was 54.05%; common isolates were Gram-negative bacilli (35%), Gram-positive cocci (25%), and Gram-positive bacilli and fungi (20% each). Systemic infection was present in 72.9% (35 of 48) of patients, with respiratory tract infection being the most common (39.5%). All eyes received intravitreal antibiotic injections, and 28 (75.7%) received vitrectomy. Children under 5 with systemic illness had a worse visual prognosis. Unfavorable outcomes were associated with Gram-positive bacilli and fungal infection. Approximately 45% of eyes worsened to phthisis.
Conclusions:
Any redness in a child with systemic infection warrants prompt ophthalmic evaluation. Children under 5 with systemic illness are associated with a worse visual prognosis. Unfavorable outcomes are linked to Gram-positive bacilli and fungal infection. |
| format | Article |
| id | doaj-art-7cfeee8cc1004705b1e80e5939616e1a |
| institution | OA Journals |
| issn | 0301-4738 1998-3689 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Ophthalmology |
| spelling | doaj-art-7cfeee8cc1004705b1e80e5939616e1a2025-08-20T02:11:15ZengWolters Kluwer Medknow PublicationsIndian Journal of Ophthalmology0301-47381998-36892025-05-0173566567110.4103/IJO.IJO_2298_24Pediatric endogenous endophthalmitis: Clinical features and treatment outcomesRidham NandaTaraprasad DasTapas Ranjan PadhiKrushna Gopal PandaMarina GerSrikanta Kumar PadhyContext: Forty-eight pediatric patients treated for endogenous endophthalmitis were analyzed. Redness and vitritis were the common symptom and sign, respectively; infection with Gram-negative bacilli was frequent. Children under 5 and with systemic illness had poorer visual prognosis. Purpose: To Analyze the demographics, clinical-microbiological profiles, and treatment outcomes of pediatric patients with endogenous endophthalmitis. Methods: We conducted a retrospective analysis of electronic medical records covering 8 years from 2016 to 2023 at a tertiary eye care center in India, focusing on patients of age <18 years diagnosed with endogenous endophthalmitis. Data extraction included demographic variables, clinical presentations, microbiological analyses, therapeutic interventions, and visual outcomes. Results: The analysis included 48 patients with an average age of 5.4 ± 4.98 years and an equal gender ratio. During the study period, 48 children with endogenous endophthalmitis were treated; it was 5% (48 of 961) of all endophthalmitis patients and 20.8% (48 of 231) of pediatric endophthalmitis patients. Common symptoms included redness (62.5%), reduced vision (20.8%), leucocoria (27.08%), pain (22.91%), and watering/discharge (29.16%). Clinical signs included vitritis (89.58%) and anterior chamber exudates/hypopyon (47.91%). Vitreous culture positivity was 54.05%; common isolates were Gram-negative bacilli (35%), Gram-positive cocci (25%), and Gram-positive bacilli and fungi (20% each). Systemic infection was present in 72.9% (35 of 48) of patients, with respiratory tract infection being the most common (39.5%). All eyes received intravitreal antibiotic injections, and 28 (75.7%) received vitrectomy. Children under 5 with systemic illness had a worse visual prognosis. Unfavorable outcomes were associated with Gram-positive bacilli and fungal infection. Approximately 45% of eyes worsened to phthisis. Conclusions: Any redness in a child with systemic infection warrants prompt ophthalmic evaluation. Children under 5 with systemic illness are associated with a worse visual prognosis. Unfavorable outcomes are linked to Gram-positive bacilli and fungal infection.https://journals.lww.com/10.4103/IJO.IJO_2298_24endogenous endophthalmitismicrobiologypediatric |
| spellingShingle | Ridham Nanda Taraprasad Das Tapas Ranjan Padhi Krushna Gopal Panda Marina Ger Srikanta Kumar Padhy Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes Indian Journal of Ophthalmology endogenous endophthalmitis microbiology pediatric |
| title | Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes |
| title_full | Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes |
| title_fullStr | Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes |
| title_full_unstemmed | Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes |
| title_short | Pediatric endogenous endophthalmitis: Clinical features and treatment outcomes |
| title_sort | pediatric endogenous endophthalmitis clinical features and treatment outcomes |
| topic | endogenous endophthalmitis microbiology pediatric |
| url | https://journals.lww.com/10.4103/IJO.IJO_2298_24 |
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