Endogenous Endophthalmitis and Missed Diagnoses
Retrospective study describes how endogenous endophthalmitis often presents without systemic symptoms
Objective:
To highlight the diagnostic challenges and clinical presentation of endogenous endophthalmitis.
Approach:
- Study Design: Retrospective review of 50 eyes from 41 patients with culture-proven endogenous endophthalmitis treated between 2013 and 2024.
- Data Collection: Examined clinical presentation, microbiological findings, systemic associations, management strategies, and visual outcomes.
Key Findings:
- 73% of patients presented in an outpatient setting; only 39% reported systemic symptoms.
- Blurred vision (88%) was the most common presenting complaint, followed by ocular pain (42%) and redness (27%).
- Candida species were the leading causative organism, accounting for 50% of positive vitreous cultures.
- 56% of patients had an identifiable infectious source, primarily from indwelling medical devices.
- 12% of patients were misdiagnosed with alternative inflammatory conditions before the correct diagnosis.
- Blood cultures were positive in 56% of cases.
Interpretation:
Endogenous endophthalmitis often presents primarily as an ocular issue, complicating timely diagnosis and treatment.
Limitations:
- Retrospective nature may limit the generalizability of findings.
- Potential for misdiagnosis may affect reported outcomes.
Conclusion:
Endogenous endophthalmitis poses significant diagnostic and therapeutic challenges, necessitating high clinical suspicion in at-risk patients.
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