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LETTER TO THE EDITOR
Year : 2018  |  Volume : 66  |  Issue : 11  |  Page : 1661

Response to comment on: Culture-positive unilateral panophthalmitis in a serology-2 positive case of dengue hemorrhagic fever


1 Department of Vitreoretinal Services, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
2 Department of Critical Care, Medica Superspecialty Hospital, Kolkata, West Bengal, India
3 Department of Molecular Microbiology, Sankara Nethralaya Referral Laboratory, Chennai, Tamil Nadu, India

Date of Web Publication25-Oct-2018

Correspondence Address:
Dr. Rupak Roy
Aditya Birla SankaraNethralaya, 147, Mukundapur, E.M. Bypass, Kolkata - 700 099, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1373_18

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How to cite this article:
Kamal R, Shah D, Sharma S, Janani MK, Kar A, Saurabh K, Roy R, Madhavan HN. Response to comment on: Culture-positive unilateral panophthalmitis in a serology-2 positive case of dengue hemorrhagic fever. Indian J Ophthalmol 2018;66:1661

How to cite this URL:
Kamal R, Shah D, Sharma S, Janani MK, Kar A, Saurabh K, Roy R, Madhavan HN. Response to comment on: Culture-positive unilateral panophthalmitis in a serology-2 positive case of dengue hemorrhagic fever. Indian J Ophthalmol [serial online] 2018 [cited 2024 Mar 28];66:1661. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2018/66/11/1661/244041



Sir,

We thank authors for taking keen interest in our article.[1] We have carefully gone through the queries raised by the authors and have responded accordingly.[2] The patient was admitted and treated in a leading urban tertiary multispeciality care setup in Eastern India, where the needles and syringes are strictly disposed off after single use. The hospital is NABH accredited, and the sterility protocols are maintained accordingly.[3] The patient developed redness in the eye on the second day posthospitalization; hence, the time span from hospitalization to acquiring infection is <48 hours. Hence, this is highly unlikely to be an infection acquired from the hospital setup.[4] The patient was from a good socioeconomic class, so the treatment was not compromised at any step due to financial constrain. The blood report of the patient showed positive NS1 IgG antigen, and dengue viral type 2 was isolated on report. The culture of intravenous solutions used in treatment was not done (as it is never routinely done at any medical setup in India); all the medications used were from single-use disposable vials and bottles.

We appreciate your thorough effort and surely accept that hospital-acquired infection can be one of the differential diagnosis. But, due to all the points mentioned above, the chances of it are extremely unlikely and seldom. Henceforth, we believe it to be a dengue-induced septicaemia, and treated accordingly, after discussion with a panel of intensivist and physician. Finally, the patient started getting metabolically s[table 1]-week post op, which again points towards a correspondence to our diagnosis.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Kamal R, Shah D, Sharma S, Janani MK, Kar A, Saurabh K, et al. Culture-positive unilateral panophthalmitis in a serology-positive case of dengue hemorrhagic fever. Indian J Ophthalmol 2018;66:1017-9.  Back to cited text no. 1
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2.
Bouza E, Grant S, Jordan C, Yook RH, Sulit HL. Bacillus cereus endogenous panophthalmitis. Arch Ophthalmol 1979;97:498-9.  Back to cited text no. 2
    
3.
Khan HA, FK Baig, R Mehboob. Nosocomial infections: Epidemiology, prevention, control and surveillance. Asian Pac J Trop Biomed 2017;7:478-82.  Back to cited text no. 3
    
4.
Schumacher M, Allignol A, Beyersmann J, Binder N, Wolkewitz M. Hospital-acquired infections – Appropriate statistical treatment is urgently needed! Int J Epidemiol 2013;42:1502-8.  Back to cited text no. 4
    




 

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