Endogenous endophthalmitis outcomes differ markedly by causative organism

A 12-year, nine-center retrospective cohort study of 305 eyes with culture-positive endogenous endophthalmitis found that presentation, source, and outcomes varied by pathogen, with Staphylococcus aureus and Streptococcus most often causing retinal detachment and gram-negative organisms, particularly Serratia, associated with the highest enucleation rates (27.7% overall, 85.7% for Serratia). The study reported low intraocular culture yield and imperfect concordance between blood and eye cultures (62% in paired cases), and identified presenting visual acuity as the most consistent predictor of final visual acuity across organism groups. The authors state these findings support organism-informed clinical decision-making and highlight a need for improved intraocular diagnostics.

Most relevant for: Patients presenting with endogenous endophthalmitis, including those with systemic infection sources such as bacteremia, urinary infections, immunosuppression, or intravenous drug use.

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