Abstract: TH-PO885
Epidemiology and Outcomes of Endophthalmitis in Chronic Dialysis Patients: A 13-Year Experience in a Tertiary Referral Center in Taiwan
Session Information
- Dialysis: Infection
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Dialysis
- 610 Dialysis: Infection
Authors
- Kuo, George, Chang-Gung Memorial Hospital, Taiwan, Taoyuan City, Taiwan
- Hsu, Hsiang-Hao, Kidney Research Center, Department of Nephrology, Linkou Chang Gung Memorial Hospital; College and School of Medicine, Chang Gung University, Taiwan, Taoyuan, Taiwan
Background
Endophthalmitis is a severe eye infection leading to disabling outcome. we would like to investigate the epidemiology and clinical features of endophthalmitis in chronic dialysis patient in a tertiary referral center.
Methods
We perfoemed chart review and searched discharge diagnosis with ICD9 encoding endophthalmitis during Jan. 2002 to Dec. 2015.
Results
In total 32 patients, 25 were endogenous and another 7 were exogenous endophthalmitis. Most patients presented with ophthalmalgia and periocular swelling , whereas half of the patients suffered blurred vision (n=16, 50%). S. aureus, K. pneumoniae, and P. aeruginosa were the most frequent causative pathogens. Dialysis vascular infection was an important focus. The final visual outcomes in both groups were worse in the chronic dialysis patients compared with previous studies of general population
Conclusion
This is the first and the largest case series focusing on endophthalmitis in chronic dialysis patients. Our study showed different pathogen spectrum, an unique bacterial origin and worse visual outcome in these group of patients. Prompt referral to ophthalmologists is important.
Characteristic of dialysis patient with endophthalmitis
| Endogenous (N = 25) | Exogenous (N = 7) | |
| Days from symptoms onset to ophthalmoogist visit | 1-30 (median: 2) | 1-7 (median: 2) |
| Recent trauma or surgery | 0 (0%) | 7 (100%) |
| Days post trauma or surgery | 3-20 (median: 4) | |
| Blurred vision | 14 (56%) | 2 (28.5%) |
| Ophthalmalgia | 25 (100%) | 7 (100%) |
| Periocular swelling | 25 (100%) | 6 (85.7%) |
| Fever | 8 (32%) | 0 (0%) |
| Septic shock | 2 (8%) | 0 (0%) |
| Respiratory failure | 2 (8%) | 0 (0%) |
| Dialysis access infection | 4 (14.8%) | 0 (0%) |
| White blood cell counts | 11 (+/- 5) | 10 (+/- 6) |
| CRP level | 71 (+/- 75) | 16 (+/- 10) |
| Bacteremia | 8 (32%) | 0 (0%) |
| Fungemia | 0 (0%) | 0 (0%) |
| Positive vitreous culture | 13 (52%) | 4 (57.1%) |
| Treatment | ||
| Intravitreous antibiotic injection (IVI) | 12 (48%) | 7 (100%) |
| Trans pars plana vitrectomy (TPPV) | 2 (8%) | 3 (42.9%) |
| Enucleation | 5 (20%) | 0 (0%) |
| Parenteral antibiotic alone | 8 (32%) | 0 (0%) |
Funding
- Government Support - Non-U.S.