How to best manage a patient with Bacillus endophthalmitis: current insights

ABSTRACT

Introduction

Bacillus endophthalmitis is a medical emergency that needs a prompt diagnosis and management to prevent further complications. Various treatment strategies are available for Bacillus endophthalmitis including intraocular antibiotics injections, anti-inflammatory medications, and interventional surgeries.

Areas covered

The aim of this article is to review the clinical manifestation and treatment strategies and outcomes of Bacillus cereus endophthalmitis.

Expert opinion

Despite current treatment modalities available for Bacillus endophthalmitis, the rate of vision and globe loss remains high. Careful attention to the patient’s symptoms and history, immediate diagnosis, and intensive treatment are necessary in the management of this illness. Future studies investigating targeted therapies against Bacillus cereus on the molecular and inflammatory level are needed.

KEYWORDS:

• Antibiotics
• Bacillus cereus
• corticosteroids
• endophthalmitis
• vision loss
• vitrectomy

Article highlights

• Bacillus endophthalmitis is a highly devastating intraocular infection caused by Bacillus cereus, which results in severe inflammation and considerable vision loss.

• Post-traumatic endophthalmitis is much more common than other types of Bacillus endophthalmitis.

• Bacillus endophthalmitis has a rapid manifestation as soon as 12-24 hours after the surgery or traumatic event. It presents with severe ocular pain, fever, periocular swelling, ocular discharge, loss of vision, and abscess. Early corneal ring infiltration is a diagnostic clue.

• Toxic anterior segment syndrome (TASS) is an important differential diagnosis.

• As an emergency condition, prompt diagnosis and aggressive medical and surgical intervention are necessary.

• Future studies focusing on targeted therapies against specific types of inflammatory molecules may be helpful.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical considerations

Ethical issues (including plagiarism, data fabrication, double publication and etc.) have been completely observed by authors.

Author contributions

All authors contributed equally to the manuscript.

Additional information

Funding

This paper was not funded.