Endophthalmitis After Staphylococcal Sepsis-Reply

In Reply.— We very much appreciate the comments of Dr Joseph about our article and would like to clarify some of the points he has raised. First, we totally agree with Dr Joseph that ocular paracentesis is important in making the diagnosis of bacterial endophthalmitis. In our discussion, we pointed out the less well-known observation that a negative anterior chamber culture does not rule out a bacterial endophthalmitis. We also agree about the lack of specificity of a polymorphonuclear leukocyte response in anterior chamber aspirate; in fact, we did not even bother to include that finding in our discussion of the possible bacterial cause of the endophthalmitis. We disagree with Dr Joseph in his statement that there is no evidence that the impaired inflammatory and immune responses in uremia can lead to a more indolent course of an infectious process. The clinical course of hepatitis B infection is more indolent