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 |