Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
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Posttraumatic Bacillus Cereus Endophthalmitis

외상 후 발생한 바실루스 세레우스 안내염 2예

Kim, Min-Jung;Chang, Bo-Hyun;Kim, In-Cheol;Lee, Dong-Wook;Ahn, Min
김민정;장보현;김인철;이동욱;안민

  • Published : 20050900
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Abstract

Purpose: We encountered two patients who developed Bacillus cereus endophthalmitis following trauma and eventually underwent enucleation, after aggressive antibiotic therapy. Methods: When removing the intraocular foreign bodies, vancomycin and ceftazidime were injected intravitreally. The patients received postoperative topical fortified antibiotics hourly and underwent intravenous antibiotic therapy. Results: After the operation, rapid corneal melting progressed to impending perforation in one patient’s eye and enucleation was done on postoperative day 11. The eye of another patient progressed to phthisis bulbi and the patient underwent enucleation on postoperative day 45. Conclusions: Bacillus cereus is one of the most aggressive and devastating organisms that causes post-traumatic endophthalmitis and results in poor visual outcome. It is thought to be better to prevent the loss of anatomic integrity and visual function than to perform early intravitreal injection of antibiotics when the operation might be delayed.

목적 : 안구천공 후 발생한 감염성 안내염으로 적극적인 항생제 치료에도 불구하고 결국 눈알적출술까지 시행한 바실루스 세레우스 안내염 2예를 경험하였고 아직 국내에 보고 된 바 없어 이를 보고하고자 한다. 대상과 방법 : 2명의 천공성 안외상 환자에서 안내 이물을 제거 시 유리체강내 vancomycin과 ceftazidime을 주사하였고 술 후 전신적 항생제 정맥주사 및 fortified 항생제를 매시간 점안치료하였다. 결과 : 이물제거술 후 한 안은 각막융해 소견 등의 감염의 빠른 진행으로 안구천공이 임박하여 술 후 11일째, 다른 안은 안구위축 소견보여 술 후 45일째 눈알적출술을 시행하였다. 결론 : 바실루스 세레우스는 독성이 강하고 빠른 진행으로 이에 의한 안내염은 예후가 매우 좋지 않으므로, 수상 후 빠른 시기에 수술하는 것이 결과가 좀 더 좋을 것으로 생각되며, 수술이 지연되는 경우 술전이라도 조기에 전방수와 유리체의 세균배양검사를 실시하면서 유리체강내 항생제 주사를 시도해 보는 것도 바실루스 세레우스 감염시 안구를 보존하는데 도움을 주는 한 방법이라 사료된다.

Keywords

References

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