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Penetrating Ocular Injury From Contaminated Eating Utensils FREE

Richard M. Feist, MD; Jennifer I. Lim, MD; Brian C. Joondeph, MD; Stephen C. Pflugfelder, MD; William F. Mieler, MD; Benjamin H. Ticho, MD; Kenneth Resnick, MD
[+] Author Affiliations

Accepted for publication September 25, 1990.

Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Fla, April 30, 1990.

Reprint requests to University of Illinois Eye and Ear Infirmary, 1855 W Taylor St, Chicago, IL 60612 (Dr Feist).


Arch Ophthalmol. 1991;109(1):63-66. doi:10.1001/archopht.1991.01080010065034
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• Although the rate of infectious endophthalmitis following penetrating ocular injury is generally less than 10%, certain settings may carry a greater risk of infection. One such setting is penetrating injury resulting from eating utensils contaminated with oral flora. We reviewed six of these injuries. Culture-positive bacterial endophthalmitis developed in four of the six eyes; only one of the eyes retained reading visual acuity (>20/50) and two eyes lost light perception. The potential for infection and limited visual outcome in this series warrants aggressive prophylaxis and treatment. The unexpected isolation of Haemophilus influenzae in two of the four infections suggests that broad-spectrum antibiotic treatment should be considered in all such injuries since less common organisms may be encountered.

REFERENCES

Rest JG, Goldstein EJC.  Management of human and animal bite wounds . Emerg Med Clin North Am . 1985;;3:117-126.
Lynch MA. Laboratory Procedures in Burket's Oral Medicine . Philadelphia, Pa: JB Lippincott; 1977;.
Callaham M.  Controversies in antibiotic choices for bite wounds . Ann Emerg Med . 1988;;17:1321-1330.
Brook I.  Human and animal bite infections . J Fam Pract . 1989;;28:713-718.
Brinton GS, Topping TM, Hyndiuk RA, Aaberg TM, Reeser FH, Abrams GW.  Posttraumatic endophthalmitis . Arch Ophthalmol . 1984;;102:547-550.
Foster RK.  Endophthalmitis . In: Duane TD, ed. Clinical Ophthalmology . New York, NY: Harper & Row Publishers Inc; 1987;;4:1-20.
Holland GN, Wallace DA, Mondino BJ, Cole SH, Ryan SJ.  Severe ocular injuries from orthodontic headgear . Arch Ophthalmol . 1985;;103:649-651.
Davey PG, Barza M, Stuart M.  Dose response of experimental Pseudomonas endophthalmitis to ciprofloxacin, gentamicin, and imipenem: evidence for resistance to 'late' treatment of infections . J Infect Dis . 1987;;155:518-523.
Vastine DW, Peyman GA, Guth SB.  Visual prognosis in bacterial endophthalmitis treated with intravitreal antibiotics . Ophthalmic Surg . 1979;;10:76-83.
Haymet T.  Results in the treatment of bacterial endophthalmitis . N Z J Ophthalmol . 1985;;13:401-409.
Laatikainen L, Tarkkanen A.  Early vitrectomy in treatment of postoperative purulent endophthalmitis . Acta Ophthalmol . 1987;;65:455-460.
Diamond JG.  Intraocular management of endophthalmitis: a systemic approach . Arch Ophthalmol . 1981;;99:96-99.
Mieler WF, Ellis MK. Williams DF, Han DP. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. In press.
Affeldt JC, Flynn HW Jr, Forster RK, Mandelbaum S, Clarkson JG, Jarus GD.  Microbial endophthalmitis resulting from ocular trauma . Ophthalmology . 1987;;94:407-413.
Packer AJ, Weingeist TA, Abrams GW.  Retinal periphlebitis as an early sign of bacterial endophthalmitis . Am J Ophthalmol . 1983;;96:66-71.
Parrish CM, O'Day DM.  Traumatic endophthalmitis . Int Ophthalmol Clin . 1984;;27:112-119.

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Rest JG, Goldstein EJC.  Management of human and animal bite wounds . Emerg Med Clin North Am . 1985;;3:117-126.
Lynch MA. Laboratory Procedures in Burket's Oral Medicine . Philadelphia, Pa: JB Lippincott; 1977;.
Callaham M.  Controversies in antibiotic choices for bite wounds . Ann Emerg Med . 1988;;17:1321-1330.
Brook I.  Human and animal bite infections . J Fam Pract . 1989;;28:713-718.
Brinton GS, Topping TM, Hyndiuk RA, Aaberg TM, Reeser FH, Abrams GW.  Posttraumatic endophthalmitis . Arch Ophthalmol . 1984;;102:547-550.
Foster RK.  Endophthalmitis . In: Duane TD, ed. Clinical Ophthalmology . New York, NY: Harper & Row Publishers Inc; 1987;;4:1-20.
Holland GN, Wallace DA, Mondino BJ, Cole SH, Ryan SJ.  Severe ocular injuries from orthodontic headgear . Arch Ophthalmol . 1985;;103:649-651.
Davey PG, Barza M, Stuart M.  Dose response of experimental Pseudomonas endophthalmitis to ciprofloxacin, gentamicin, and imipenem: evidence for resistance to 'late' treatment of infections . J Infect Dis . 1987;;155:518-523.
Vastine DW, Peyman GA, Guth SB.  Visual prognosis in bacterial endophthalmitis treated with intravitreal antibiotics . Ophthalmic Surg . 1979;;10:76-83.
Haymet T.  Results in the treatment of bacterial endophthalmitis . N Z J Ophthalmol . 1985;;13:401-409.
Laatikainen L, Tarkkanen A.  Early vitrectomy in treatment of postoperative purulent endophthalmitis . Acta Ophthalmol . 1987;;65:455-460.
Diamond JG.  Intraocular management of endophthalmitis: a systemic approach . Arch Ophthalmol . 1981;;99:96-99.
Mieler WF, Ellis MK. Williams DF, Han DP. Retained intraocular foreign bodies and endophthalmitis. Ophthalmology. In press.
Affeldt JC, Flynn HW Jr, Forster RK, Mandelbaum S, Clarkson JG, Jarus GD.  Microbial endophthalmitis resulting from ocular trauma . Ophthalmology . 1987;;94:407-413.
Packer AJ, Weingeist TA, Abrams GW.  Retinal periphlebitis as an early sign of bacterial endophthalmitis . Am J Ophthalmol . 1983;;96:66-71.
Parrish CM, O'Day DM.  Traumatic endophthalmitis . Int Ophthalmol Clin . 1984;;27:112-119.

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