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 visit1-30 (median: 2)1-7 (median: 2)
Recent trauma or surgery0 (0%)7 (100%)
Days post trauma or surgery 3-20 (median: 4)
Blurred vision14 (56%)2 (28.5%)
Ophthalmalgia25 (100%)7 (100%)
Periocular swelling25 (100%)6 (85.7%)
Fever8 (32%)0 (0%)
Septic shock2 (8%)0 (0%)
Respiratory failure2 (8%)0 (0%)
Dialysis access infection4 (14.8%)0 (0%)
White blood cell counts11 (+/- 5)10 (+/- 6)
CRP level71 (+/- 75)16 (+/- 10)
Bacteremia8 (32%)0 (0%)
Fungemia0 (0%)0 (0%)
Positive vitreous culture13 (52%)4 (57.1%)
Treatment  
Intravitreous antibiotic injection (IVI)12 (48%)7 (100%)
Trans pars plana vitrectomy (TPPV)2 (8%)3 (42.9%)
Enucleation5 (20%)0 (0%)
Parenteral antibiotic alone8 (32%)0 (0%)
   
   

Funding

  • Government Support - Non-U.S.