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Table 2 Summary of clinical findings and treatment in 6 patients with post-phacoemulsification endophthalmitis

From: An outbreak of post cataract Pseudomonas aeruginosa acute endophthalmitis in Egypt

Patient no. VA Clinical signs Therapy before culture and sensitivity Therapy after culture and sensitivity Outcome
1 No LP Eyelid edema, conjunctival congestion, corneal edema, exudates in AC, 2-mm hypopyon, ciliary injection hypopyon, and increase IOP Intravitreal antibiotic injection + fortum, vancomycin, amikacin ED/h + cefobid 1 g IM/day for 3 days + augmentine 1 g oral/12 h + flagyl 500 mg/12 h + combigan ED 2td + cycloplegic ED 3td Intravitreal antibiotic injection + Tienam 50 mg 3td IV + Amikacin fortified ED/h + vegamoxED/2 h + pred forte ED 6td + cycloplegic and combigan ED 3td + cataflam/12 h + zantak 150 mg/12 h LP
2 LP Eyelid edema, conjunctival congestion, corneal edema, exudates in AC, and increase IOP Intravitreal antibiotic injection + fortum, vancomycin, amikacin ED/h + cefobid 1 g IM/day for 3 days + augmentine 1 g oral/12 h + flagyl 500 mg/12 h + combiganED 2td + cycloplegic ED 3td Intravitreal antibiotic injection+ Tienam 50 mg 3td IV + Amikacin fortified ED/h + vegamoxED/2 h + pred forte ED 6td + cycloplegic and combigan ED 3td + cataflam/12 h + zantak 150 mg/12 h LP
3 LP Eyelid edema, conjunctival congestion, corneal edema and infiltration. AC exudates. Intravitreal antibiotic injection + fortum, vancomycin, amikacin ED /h + cefobid 1 g IM/day for 3 days + augmentine 1 g oral/12 h + flagyl 500 mg/12 h + combiganED 2td + cycloplegic ED 3td Intravitreal antibiotic injection+ Tienam 50 mg 3td IV + Amikacin fortified ED/h + vegamoxED/2 h + pred forte ED 6td + cycloplegic and combigan ED 3td + Oflox.ED 1 × 5 + cataflam/12 h + zantak 150 mg/12 h LP
4 LP Eyelid edema, conjunctival congestion, corneal edema, exudates in AC. Intravitreal antibiotic injection + fortum, vancomycin, amikacin ED /h + cefobid 1 g IM/day for 3 days + augmentine 1 g oral/12 h + flagyl500mg/12 h + combiganED 2td + cycloplegic ED 3td Intravitreal antibiotic injection+ Tienam 50 mg 3td IV + Amikacin fortified ED/h + vegamoxED/2 h + pred forte ED 6td + cycloplegic and combigan ED 3td + cataflam/12 h + zantak 150 mg/12 h LP
5 LP Conjunctival congestion, Chemosis, corneal edema, exudates in AC. Ac wash with vancomycin, fortum, Vancomycin, Amikacin ED /h + cefobid1g IM /day for 3 days + augmentine 1 g oral/12 h + flagyl 500 mg/12 h + combiganED 2td + cycloplegic ED 3td As above + oflox.ED 5td Marked improvement, yet an amblyopic eye needs prolonged follow up to access VA
6 LP Eyelid edema, discharge, conjunctival congestion, corneal edema, exudates in AC. Ac wash with vancomycin, fortum, Vancomycin, Amikacin ED /h + cefobid1g IM /day for 3 days + augmentine 1 g oral/12 h + flagyl 500 mg/12 h + combiganED 2td + cycloplegic ED 3td Intravitreal antibiotic injection+ Tienam 50 mg 3td IV + amikacin fortified ED/h + vegamox ED/2 h + pred forte ED 6td + cycloplegic and combigan ED 3td + cataflam/12 h + zantak 150 mg/12 h HM
  1. AC anterior chamber, 2td twice daily, HM hand motion, IOL intraocular lens, LP light perception, 3td three times daily, VA visual acuity, ED eye drops, IM intra-muscular, IV intravenous, VA visual acuity