Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- 109 Postoperative wound infections
- 110 Trauma-related infection
- 111 Infected implants
- 112 Infection in the burn-injured patient
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
111 - Infected implants
from Part XIV - Infections related to surgery and trauma
Published online by Cambridge University Press: 05 April 2015
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Part I Clinical syndromes: general
- Part II Clinical syndromes: head and neck
- Part III Clinical syndromes: eye
- Part IV Clinical syndromes: skin and lymph nodes
- Part V Clinical syndromes: respiratory tract
- Part VI Clinical syndromes: heart and blood vessels
- Part VII Clinical syndromes: gastrointestinal tract, liver, and abdomen
- Part VIII Clinical syndromes: genitourinary tract
- Part IX Clinical syndromes: musculoskeletal system
- Part X Clinical syndromes: neurologic system
- Part XI The susceptible host
- Part XII HIV
- Part XIII Nosocomial infection
- Part XIV Infections related to surgery and trauma
- 109 Postoperative wound infections
- 110 Trauma-related infection
- 111 Infected implants
- 112 Infection in the burn-injured patient
- Part XV Prevention of infection
- Part XVI Travel and recreation
- Part XVII Bioterrorism
- Part XVIII Specific organisms: bacteria
- Part XIX Specific organisms: spirochetes
- Part XX Specific organisms: Mycoplasma and Chlamydia
- Part XXI Specific organisms: Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific organisms: fungi
- Part XXIII Specific organisms: viruses
- Part XXIV Specific organisms: parasites
- Part XXV Antimicrobial therapy: general considerations
- Index
- References
Summary
This chapter addresses infections associated with artificial devices of a specialized nature. The rate of infection is generally low, but collectively, there are millions of these devices implanted yearly, so the infections are not rare. Optimal treatment requires participation of surgical specialists experienced in the management of these difficult infections, especially for pseudophakic endophthalmitis, in which therapy includes intraocular injections.
Intraocular lens-associated infections (pseudophakic endophthalmitis)
Pseudophakic endophthalmitis is thought to occur as a consequence of contamination with flora of conjunctival sac or lid margin at the time of surgery. There also have been reports of infections arising from contamination of lenses and neutralizing and storage solutions.
The differential diagnosis of endophthalmitis following cataract extraction includes sterile inflammation as well as bacterial and fungal infection. The most common presenting signs and symptoms include pain in the involved eye, decreased visual acuity, red eye, lid edema, hypopyon, and absent or poor red reflex. A single bacterial strain is usually isolated; the most common pathogen is a coagulase-negative staphylococcus (approximately 50% in one large series) followed by Staphylococcus aureus. Virtually any microorganism can be implicated. Delayed onset pseudophakic endophthalmitis has been reported after uncomplicated initial cataract surgery. This entity presents one or more months after surgery and is manifest by waxing and waning ocular inflammation. The leading cause of delayed-onset pseudophakic endophthalmitis is Propionibacterium acnes. Diagnostic evaluation requires aqueous and vitreous samples for Gram stain and culture. Vitrectomy may have therapeutic as well as diagnostic value.
- Type
- Chapter
- Information
- Clinical Infectious Disease , pp. 738 - 740Publisher: Cambridge University PressPrint publication year: 2015