See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research article
Pitipol Choopong
Faculty of Medicine Siriraj Hospital, Mahidol University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8857-8488
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.
Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.
Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively).
Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.
Keywords
atypical mycobacteria, non-tuberculous mycobacteria, endophthalmitis, Mycobacterium haemophilum, Mycobacterium fortuitum, Mycobacterium abscessus
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 08 Nov, 2020
No comments provided
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 27 Oct, 2020
Editor invited
On 27 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 14 Oct, 2020
Editor assigned
On 05 Jul, 2020
Submission checks complete
On 04 Jul, 2020
Editor invited
On 04 Jul, 2020
Version 2
Posted 11 May, 2020
No comments provided
Editorial decision: Minor revision
On 30 Jun, 2020
Review #1 received
Received 20 May, 2020
Reviewers invited
Invitations sent on 19 May, 2020
Reviewer #1 agreed
On 19 May, 2020
Editor assigned
On 27 Apr, 2020
Submission checks complete
On 26 Apr, 2020
Editor invited
On 26 Apr, 2020
No comments provided
Editorial decision: Major revision
On 27 Mar, 2020
Review #3 received
Received 22 Mar, 2020
Review #2 received
Received 22 Mar, 2020
Reviewer #3 agreed
On 09 Mar, 2020
Reviewer #2 agreed
On 07 Mar, 2020
Reviewer #1 agreed
On 02 Mar, 2020
Review #1 received
Received 02 Mar, 2020
Reviewers invited
Invitations sent on 01 Mar, 2020
Editor assigned
On 20 Feb, 2020
First submitted
On 19 Feb, 2020
Submission checks complete
On 19 Feb, 2020
Editor invited
On 19 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Pitipol Choopong
Faculty of Medicine Siriraj Hospital, Mahidol University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8857-8488
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
No community comments so far
Submission checks complete
On 19 Nov, 2020
Editorial decision: Accept
On 08 Nov, 2020
No comments provided
Editor assigned
On 28 Oct, 2020
Submission checks complete
On 27 Oct, 2020
Editor invited
On 27 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 14 Oct, 2020
Editor assigned
On 05 Jul, 2020
Submission checks complete
On 04 Jul, 2020
Editor invited
On 04 Jul, 2020
Version 2
Posted 11 May, 2020
No comments provided
Editorial decision: Minor revision
On 30 Jun, 2020
Review #1 received
Received 20 May, 2020
Reviewers invited
Invitations sent on 19 May, 2020
Reviewer #1 agreed
On 19 May, 2020
Editor assigned
On 27 Apr, 2020
Submission checks complete
On 26 Apr, 2020
Editor invited
On 26 Apr, 2020
No comments provided
Editorial decision: Major revision
On 27 Mar, 2020
Review #3 received
Received 22 Mar, 2020
Review #2 received
Received 22 Mar, 2020
Reviewer #3 agreed
On 09 Mar, 2020
Reviewer #2 agreed
On 07 Mar, 2020
Reviewer #1 agreed
On 02 Mar, 2020
Review #1 received
Received 02 Mar, 2020
Reviewers invited
Invitations sent on 01 Mar, 2020
Editor assigned
On 20 Feb, 2020
First submitted
On 19 Feb, 2020
Submission checks complete
On 19 Feb, 2020
Editor invited
On 19 Feb, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.
Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.
Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively).
Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
Loading...