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Overview and Current Recommendations for the Treatment of Bacterial Endophthalmitis

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Orbital Cellulitis and Periorbital Infections

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Abstract

Endophthalmitis is a severe infection involving the entire globe and its contents. It can be caused by exogenous or endogenous bacteria, fungus, or parasites. Exogenous endophthalmitis typically occurs in the setting of recent intraocular surgery or trauma. Endogenous endophthalmitis occurs when there is intraocular seeding of an infectious nidus originating from a distant source. Affected patients generally present with pain, decreased vision, and ocular injection. Diagnosis can be made from a combination of physical examination findings, B-scan ultrasonography, and vitreous tap. Intravitreal antibiotics are the mainstay of treatment, and early vitrectomy is recommended in advanced cases. Unfortunately, endophthalmitis is generally associated with poor prognosis. Thus, prevention and early recognition of endophthalmitis are critical. While most cases of endophthalmitis are responsive to medical or surgical therapy, progression of infection to the surrounding orbital structures can rarely occur. This results in a devastating condition called panophthalmitis which may require evisceration or enucleation.

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Abbreviations

BRE:

Bleb-related endophthalmitis

EE:

Endogenous endophthalmitis

EVS:

Endophthalmitis Vitrectomy Study

PK:

Penetrating keratoplasty

POE:

Postoperative endophthalmitis

PPV:

Pars plana vitrectomy

Va:

Visual acuity

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  1. Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA

    Jennifer Murdock MD, Ahmar Sajjad MD, Jessica Gomez MD & Christina Y. Weng MD, MBA

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    Michael T. Yen

  2. Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA

    Thomas E. Johnson

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Murdock, J., Sajjad, A., Gomez, J., Weng, C.Y. (2018). Overview and Current Recommendations for the Treatment of Bacterial Endophthalmitis. In: Yen, M., Johnson, T. (eds) Orbital Cellulitis and Periorbital Infections. Springer, Cham. https://doi.org/10.1007/978-3-319-62606-2_15

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