An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection

Himadri Choudhury,1 Animesh Jindal,1 Avinash Pathengay,1 Harry W Flynn Jr21LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To report an outbreak of...

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Autores principales:	Choudhury H, Jindal A, Pathengay A, Flynn HW Jr
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2015
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/27f71f8df2bb4e0c95ca6bfd303fa032
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spelling	oai:doaj.org-article:27f71f8df2bb4e0c95ca6bfd303fa0322021-12-02T02:48:25ZAn outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection1177-5483https://doaj.org/article/27f71f8df2bb4e0c95ca6bfd303fa0322015-06-01T00:00:00Zhttp://www.dovepress.com/an-outbreak-of-ralstonia-pickettii-endophthalmitis-following-intravitr-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Himadri Choudhury,1 Animesh Jindal,1 Avinash Pathengay,1 Harry W Flynn Jr21LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To report an outbreak of endophthalmitis in three eyes of two patients following intravitreal methotrexate, caused by Ralstonia pickettii.Design: Retrospective, noncomparative, consecutive case series.Methods: Medical records and microbiology results of two patients who presented with acute endophthalmitis following intravitreal methotrexate injection in November 2013 were reviewed.Results: Following intravitreal injections, the patients experienced pain and decrease in vision in the affected eye within 24 hours of receiving intravitreal methotrexate injection. The presenting visual acuity in case 1 was 20/50 in the left eye. The presenting visual acuity in case 2 was hand motions in the right eye and counting fingers at 1 m in the left eye. Both the patients received methotrexate prepared in the same manufacturing facility. Both the patients underwent vitreous biopsy and intravitreal injection of vancomycin 1 mg/0.1 mL, amikacin 400 µg/0.1 mL, and dexamethasone 400 µg/0.1 mL. Microbiology cultures from vitreous, and used and unused vials of methotrexate from the same batch grew R. pickettii. After 8 months of follow-up, both the patients had visual acuity 20/60 or better.Conclusion: R. pickettii can be rarely associated with outbreak of endophthalmitis. Timely intervention can be associated with good visual outcome in such patients.Keywords: Ralstonia pickettii, intravitreal injection, intravitreal methotrexateChoudhury HJindal APathengay AFlynn HW JrDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 1117-1120 (2015)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Choudhury H Jindal A Pathengay A Flynn HW Jr An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
description	Himadri Choudhury,1 Animesh Jindal,1 Avinash Pathengay,1 Harry W Flynn Jr21LV Prasad Eye Institute, GMR Varalakshmi Campus, Visakhapatnam, India; 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USAPurpose: To report an outbreak of endophthalmitis in three eyes of two patients following intravitreal methotrexate, caused by Ralstonia pickettii.Design: Retrospective, noncomparative, consecutive case series.Methods: Medical records and microbiology results of two patients who presented with acute endophthalmitis following intravitreal methotrexate injection in November 2013 were reviewed.Results: Following intravitreal injections, the patients experienced pain and decrease in vision in the affected eye within 24 hours of receiving intravitreal methotrexate injection. The presenting visual acuity in case 1 was 20/50 in the left eye. The presenting visual acuity in case 2 was hand motions in the right eye and counting fingers at 1 m in the left eye. Both the patients received methotrexate prepared in the same manufacturing facility. Both the patients underwent vitreous biopsy and intravitreal injection of vancomycin 1 mg/0.1 mL, amikacin 400 µg/0.1 mL, and dexamethasone 400 µg/0.1 mL. Microbiology cultures from vitreous, and used and unused vials of methotrexate from the same batch grew R. pickettii. After 8 months of follow-up, both the patients had visual acuity 20/60 or better.Conclusion: R. pickettii can be rarely associated with outbreak of endophthalmitis. Timely intervention can be associated with good visual outcome in such patients.Keywords: Ralstonia pickettii, intravitreal injection, intravitreal methotrexate
format	article
author	Choudhury H Jindal A Pathengay A Flynn HW Jr
author_facet	Choudhury H Jindal A Pathengay A Flynn HW Jr
author_sort	Choudhury H
title	An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
title_short	An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
title_full	An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
title_fullStr	An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
title_full_unstemmed	An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
title_sort	outbreak of ralstonia pickettii endophthalmitis following intravitreal methotrexate injection
publisher	Dove Medical Press
publishDate	2015
url	https://doaj.org/article/27f71f8df2bb4e0c95ca6bfd303fa032
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An outbreak of Ralstonia pickettii endophthalmitis following intravitreal methotrexate injection

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