Postoperative Serratia Marcescens Endophthalmitis with Cheesy White Hypopyon-A Case Report and Review

白內障術後沙雷氏黏質菌眼內炎之病例報告與文獻回顧

陳美靜(Mei-Chin Chen) ； 林人傑(Jen-Chieh Lin) ； 尤之浩(Jy-Haw Yu)

《中華民國眼科醫學會雜誌》 47卷4期 (2008/12) Pp. 462-466

https://doi.org/10.30048/ACTASOS.200812.0011

摘要

目的：報告一個白內障術後之沙雷氏黏質菌眼內炎之病例。
方法：病例報告。
結果，一位87歲男性於白內障術後第二天呈現患眼疼痛併視力減退之情形，患眼前房與前玻璃體腔呈現大量乳酪狀白色膿瘍：病患本身除了高血壓與關節炎之外，並無其他身體上之疾病。玻璃體抽出物培養出沙雷氏黏質菌(Serratia marcescens)，而血液標本並無任何發現。經過緊急前玻璃體切除、人工水晶體移除以及根據敏感性試驗使用玻璃體內注射Amikacin與Vancomycin之後，病況得到控制，但是患眼最後還是呈現眼球萎縮並失去視力。
結論：大量乳酪狀白色腳鳥之表現可作為急性術後眼內炎之診斷與治療方針之參考。

並列摘要

Purpose: To report a case of Serratia marcescens endophthalmitis with cheesy white hypopyon after cataract surgery.
Method: Case report.
Result: An 87-year-old man presented with a painful left eye 2 days after a cataract extraction by phacoemulsification with a clear-corneal incision. Apart from hypertension and arthritis, he had no systemic illness. Mechanical anterior vitrectomy, IOL removal and intravitreous vancomycin and ceftazidime were administered immediately. Fulminant cheesy white pus and hypopyon were noted during vitrectomy. Culture showed Serratia marcescens. Despite aggressive vitrectomy with intensive systemic and topical antibiotic therapy, the patient eventually had total vision loss in the affected eye.
Conclusion: Acute fulminant cheesy white pus and hypopyon instead of pink hypopyon, ＜||＞red-brown fluid＜||＞ in the vitreous, or dark hypopyon may be useful in aiding diagnostic and therapeutic decisions in postoperative Serratia marcescens endophthalmitis.

並列關鍵字

Cataract surgery ； cheesy white hypopyon ； Serratia marcescens