13.5.1
Endogenous Bacterial Endophthalmitis
Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 13, Ophthalmic Conditions.
Clinical Description
- Originates from sources within the body
Signs and Symptoms
- Decreased vision, pain and tearing, purulent discharge
- Conjunctiva injection, hypopyon, corneal oedema, vitritis, reduced fundus view secondary to vitreous inflammation.
Investigations
- Vitreous tap (microscopy, culture, and sensitivity)
Treatment
- The choice of agents is dependent on culture and sensitivity results
- Empirically treat endophthalmitis with systemic antibiotics with Ceftazidime 1g 12 hourly and Vancomycin 1g every 12hrs for 2-3 weeks
- Isolated endophthalmitis is treated with oral Ciprofloxacin 750mg 12 hourly for 7- 14 days and intravitreal antibiotics as in postoperative endophthalmitis below.
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