Bacterial Infections Flashcards
Acute PostOp Endophthalmitis
intraocular infection after recent intraocular surgery
within 6 weeks
Surgeries likely to cause Acute PostOp Endophthalmitis
cataract and PKP
vitrectomy
filtering blebs
Causes of Endophthalmitis
Gram + = Staph epiderimidis
Gram -
fungal, protozoan, parasitic, viral
Symptoms of Endophthalmitis
abrupt onset of floaters, decreased vision, and eye pain
Signs of Endophthalmitis
hypopyon and fibrinous exudates in AC
Vitritis
Diagnosing Endophthalmitis
ultrasound to see behind and view vitritis; show scleral- choroidal thickening
culturing vitreal sample
AC and conj swabs
Endophthalmitis Tx
HM or better- intravitreal antibiotics
LP- pars plana vitrectomy followed by intravitreal antibiotics
steroids to limit inflammation
Prognosis for Endophthalmitis with S. epidermidis
better than 20/40 with Tx
Prognosis for Endophthalmitis with S. aureus, Strep, and gram -
poor
Delayed Onset PostOp Endophthalmitis
can occur years after surgery
Symptoms of Delayed Onset PostOp Endophthalmitis
gradual onset of decreased vision and photophobia
Signs of Delayed Onset of PostOP Endophthalmitis
vitritis low grade grade anterior uveitis keratic precipitates hypopyon white plaque on IOL or post capsule
Bleb- Associated Endophthalmitis
can occur anytime after glaucoma filtering surgery
more frequent with anti-metabolites and for inferior blebs
Tx for Bleb- Associated Endophthalmitis
antibiotics initially for blebitis
intravitreal antibiotics
Traumatic Endophthalmitis
infection following penetration injury
Symptoms of Traumatic Endophthalmitis
decreased vision
increased pain after injury
Signs of Traumatic Endophthalmitis
hypopyon with increase of vitritis
Patients Susceptible to Endogenous Endophthalmitis
Septic
immunocompromised
IV drug users; indwelling catheters
Symptoms of Endogenous Endophthalmitis
pain progressively blurred vision floaters photophobia headache systemic unhealthiness
Signs of Endogenous Endophthalmitis
swollen lids and corneal edema
anterior uveitis
focal subretinal abscess/ heme
vitreous haze/ abscess
Confirming Endogenous Endophthalmitis
ocular cultures
cultures of blood, urine, catheter tips
Cause of Syphillis
Treponema pallidum
Primary Phase of Syphillis
painless ulcer (chancre) at site of infection
Secondary Phase of Syphillis
rash on trunk, palms, soles of feet
anterior and posterior uveitis
Tertiary Phase of Syphillis
neurosyphillis
cardiovascular problems
Argyll Robertson pupil
Diagnosis of Ocular Syphillis
blood/ CSF tests
Treatment for Syphillis
IV or IM penicillin
Cause of Ocular Tuberculosis
Mycobacterium tuberculosis/ bovis
Ocular Tuberculosis
chronic granulomatis infection
can affect anterior or posterior segments, orbit, around lid
Spread of Tuburculosis
inhalation
Signs of Ocular Tuberculosis
anterior uveitis
granulomas
periphlebitis
Tuburculosis Granulomas can appear on…
choroid
retina
Tx for Ocular Tuburculosis
oral antibiotics
Cause of Lyme Disease
Borrelia burgdorferi
tick bite
Lyme Disease can cause…..
choroiditis
neuroretinitis
periphlebitis
skin rash at bite size
Tx for Lyme Disease
oral/ IV antibiotics
Cat Scratch Disease
from cat bites or scratches, normally kittens
Cat Scratch Disease causes….
macular stars
neuroretinitis
