Bacterial Infections Flashcards by Travis Whitlow

Acute PostOp Endophthalmitis

intraocular infection after recent intraocular surgery

within 6 weeks

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Surgeries likely to cause Acute PostOp Endophthalmitis

cataract and PKP
vitrectomy
filtering blebs

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Causes of Endophthalmitis

Gram + = Staph epiderimidis
Gram -
fungal, protozoan, parasitic, viral

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Symptoms of Endophthalmitis

abrupt onset of floaters, decreased vision, and eye pain

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Signs of Endophthalmitis

hypopyon and fibrinous exudates in AC

Vitritis

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Diagnosing Endophthalmitis

ultrasound to see behind and view vitritis; show scleral- choroidal thickening
culturing vitreal sample
AC and conj swabs

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Endophthalmitis Tx

HM or better- intravitreal antibiotics
LP- pars plana vitrectomy followed by intravitreal antibiotics
steroids to limit inflammation

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Prognosis for Endophthalmitis with S. epidermidis

better than 20/40 with Tx

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Prognosis for Endophthalmitis with S. aureus, Strep, and gram -

poor

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Delayed Onset PostOp Endophthalmitis

can occur years after surgery

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Symptoms of Delayed Onset PostOp Endophthalmitis

gradual onset of decreased vision and photophobia

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Signs of Delayed Onset of PostOP Endophthalmitis

vitritis
low grade grade anterior uveitis
keratic precipitates
hypopyon
white plaque on IOL or post capsule

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Bleb- Associated Endophthalmitis

can occur anytime after glaucoma filtering surgery

more frequent with anti-metabolites and for inferior blebs

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Tx for Bleb- Associated Endophthalmitis

antibiotics initially for blebitis

intravitreal antibiotics

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Traumatic Endophthalmitis

infection following penetration injury

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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