Pediatric Infectious Endophthalmitis: A Case Series.

To the Editors: We wish to share the results of a case series on pediatric endophthalmitis. Because this is not a common entity, it is our hope that this short review will serve to highlight the characteristics, treatment, and prognosis of pediatric endophthalmitis. During the 11-year retrospective study period, 7 eyes were identified. Of these cases, open globe injuries were the most common etiology of endophthalmitis (3 of 7 eyes, 1 intraocular foreign body). This result is similar to those reported in the literature. Thordsen et al.1 collected data from 1995 to 2005 and their results revealed that 44% of endophthalmitis cases originated with open globe injuries (7 eyes, 3 intraocular foreign bodies). Weinstein et al.2 reported on findings from the 1970s and found that 86% of pediatric cases had traumatic endophthalmitis from open globe injuries (19 eyes, 5 intraocular foreign bodies). Endophthalmitis developed at a mean duration of 2 days after open globe repair in the current series. The results of our series are summarized in Table 1. Most cases were exogenous. The initial treatment was pars plana vitrectomy with vitreous biopsy and intravitreal antibiotics. Vancomycin and ceftazidime were used intravitreally except in one patient with an allergy. All patients were treated with intravenous vancomycin and a third-generation cephalosporin. One eye had delayed closure of an open globe injury. Advanced infectious endophthalmitis was diagnosed at presentation in one eye, which necessitated primary enucleation. When considering treatment of endophthalmitis in children, one must recognize the distinct microbiology of the condition. One of our postoperative cases had bleb-related endophthal-