{"title":"腱膜下万古霉素注射治疗继发于耐甲氧西林金黄色葡萄球菌内源性眼内炎的视网膜下脓肿:病例报告和文献综述。","authors":"Lucas W Rowe, Luke G McVeigh, Amir R Hajrasouliha","doi":"10.1097/ICB.0000000000001398","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To report the use of a subtenon's vancomycin injection for the treatment of subretinal abscess secondary to methicillin-resistant Staphylococcus aureus endogenous endophthalmitis.</p><p><strong>Methods: </strong>A 17-year-old man developed endogenous endophthalmitis with subretinal abscess in his right eye secondary to methicillin-resistant Staphylococcus aureus bacteremia from axillary necrotizing fasciitis. Despite prompt treatment with IV vancomycin and an intravitreal vancomycin injection, the patient displayed minimal improvement. The patient was subsequently treated with a subtenon's vancomycin injection. The injection technique is described in detail, as well as a review of the treatment options available for bacterial subretinal abscesses.</p><p><strong>Results: </strong>On presentation, examination revealed minimal vitritis and a large yellow subretinal abscess superotemporally extending close to the macula with subretinal fluid inferotemporally involving the macula. Four days postintravitreal vancomycin injection, the abscess remained stable and the patient developed an exudative detachment temporally. Vancomycin was injected superotemporally in the subtenon's space with no complications during the procedure or during his postoperative recovery. At seven days postinjection, the subretinal abscess and exudative retinal detachment resolved completely with necrosis at the area of previous abscess.</p><p><strong>Conclusion: </strong>We present the first successful case of subtenon's vancomycin injection for the treatment of bacterial subretinal abscess. Our case demonstrates that subtenon's injection of antibiotics is a safe and effective nonsurgical management option for bacterial subretinal abscesses.</p>","PeriodicalId":53580,"journal":{"name":"Retinal Cases and Brief Reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"SUBTENON'S VANCOMYCIN INJECTION FOR SUBRETINAL ABSCESS SECONDARY TO METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS ENDOGENOUS ENDOPHTHALMITIS: A CASE REPORT AND LITERATURE REVIEW.\",\"authors\":\"Lucas W Rowe, Luke G McVeigh, Amir R Hajrasouliha\",\"doi\":\"10.1097/ICB.0000000000001398\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To report the use of a subtenon's vancomycin injection for the treatment of subretinal abscess secondary to methicillin-resistant Staphylococcus aureus endogenous endophthalmitis.</p><p><strong>Methods: </strong>A 17-year-old man developed endogenous endophthalmitis with subretinal abscess in his right eye secondary to methicillin-resistant Staphylococcus aureus bacteremia from axillary necrotizing fasciitis. Despite prompt treatment with IV vancomycin and an intravitreal vancomycin injection, the patient displayed minimal improvement. The patient was subsequently treated with a subtenon's vancomycin injection. The injection technique is described in detail, as well as a review of the treatment options available for bacterial subretinal abscesses.</p><p><strong>Results: </strong>On presentation, examination revealed minimal vitritis and a large yellow subretinal abscess superotemporally extending close to the macula with subretinal fluid inferotemporally involving the macula. Four days postintravitreal vancomycin injection, the abscess remained stable and the patient developed an exudative detachment temporally. Vancomycin was injected superotemporally in the subtenon's space with no complications during the procedure or during his postoperative recovery. At seven days postinjection, the subretinal abscess and exudative retinal detachment resolved completely with necrosis at the area of previous abscess.</p><p><strong>Conclusion: </strong>We present the first successful case of subtenon's vancomycin injection for the treatment of bacterial subretinal abscess. Our case demonstrates that subtenon's injection of antibiotics is a safe and effective nonsurgical management option for bacterial subretinal abscesses.</p>\",\"PeriodicalId\":53580,\"journal\":{\"name\":\"Retinal Cases and Brief Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Retinal Cases and Brief Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/ICB.0000000000001398\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Retinal Cases and Brief Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/ICB.0000000000001398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:报告使用腱膜下万古霉素注射液治疗继发于耐甲氧西林金黄色葡萄球菌(MRSA)内源性眼内炎(EE)的视网膜下脓肿的方法:一名 17 岁的男性因腋下坏死性筋膜炎引发 MRSA 菌血症,继发右眼 EE 和视网膜下脓肿。尽管患者及时接受了静脉注射万古霉素和玻璃体内注射万古霉素的治疗,但病情改善甚微。随后,患者接受了腱膜下万古霉素注射治疗。本文详细介绍了注射技术,并回顾了细菌性视网膜下脓肿的治疗方案:就诊时,检查结果显示患者有轻微的玻璃体炎,颞上部有一个大的黄色视网膜下脓肿,靠近黄斑,颞下部有视网膜下积液,累及黄斑。静脉注射万古霉素四天后,脓肿保持稳定,患者颞部出现渗出性脱离。在颞下间隙注射万古霉素,术中和术后恢复期间均未出现并发症。注射后七天,视网膜下脓肿和渗出性视网膜脱离完全消退,之前的脓肿部位出现坏死:我们介绍了首例腱膜下万古霉素注射治疗细菌性视网膜下脓肿的成功病例。我们的病例表明,腱膜下注射抗生素是治疗细菌性视网膜下脓肿的一种安全有效的非手术疗法。
SUBTENON'S VANCOMYCIN INJECTION FOR SUBRETINAL ABSCESS SECONDARY TO METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS ENDOGENOUS ENDOPHTHALMITIS: A CASE REPORT AND LITERATURE REVIEW.
Purpose: To report the use of a subtenon's vancomycin injection for the treatment of subretinal abscess secondary to methicillin-resistant Staphylococcus aureus endogenous endophthalmitis.
Methods: A 17-year-old man developed endogenous endophthalmitis with subretinal abscess in his right eye secondary to methicillin-resistant Staphylococcus aureus bacteremia from axillary necrotizing fasciitis. Despite prompt treatment with IV vancomycin and an intravitreal vancomycin injection, the patient displayed minimal improvement. The patient was subsequently treated with a subtenon's vancomycin injection. The injection technique is described in detail, as well as a review of the treatment options available for bacterial subretinal abscesses.
Results: On presentation, examination revealed minimal vitritis and a large yellow subretinal abscess superotemporally extending close to the macula with subretinal fluid inferotemporally involving the macula. Four days postintravitreal vancomycin injection, the abscess remained stable and the patient developed an exudative detachment temporally. Vancomycin was injected superotemporally in the subtenon's space with no complications during the procedure or during his postoperative recovery. At seven days postinjection, the subretinal abscess and exudative retinal detachment resolved completely with necrosis at the area of previous abscess.
Conclusion: We present the first successful case of subtenon's vancomycin injection for the treatment of bacterial subretinal abscess. Our case demonstrates that subtenon's injection of antibiotics is a safe and effective nonsurgical management option for bacterial subretinal abscesses.