Endophthalmitis in a pediatric population

Abstract

A study of 22 consecutive cases of suspected endophthalmitis in children disclosed that 68% (15/22) were male with a mean age of 7.4 years. In contrast to adult populations, 86% (19/22) followed trauma in this series. Cultures were performed in 18 cases yielding positive results in 8 cases. Anterior chamber paracentesis was positive in 6/10 attempts, vitreous cultures in 1/4, and wound cultures in 2/7. Gram-positive organisms were recovered in 75% (6/8) of the cultures, stressing the importance of coverage for these organisms before culture results are known. Although cultures should be obtained as soon as possible, the initiation of antibiotics beforehand should not deter one from obtaining cultures as 75% (6/8) of patients with positive cultures had preculture antibiotics. Fourteen patients were diagnosed within 48 hours of the precipitating event, and all of these cases followed trauma. Three of 7 patients with positive cultures and 1 of 10 patients with negative cultures had final visual acuities of 20/200 or better. The lack of correlation between a positive culture and a poor visual outcome suggests that the final visual acuity depends not only on the endophthalmitis, but also on the extent of trauma.