Ooishi M, Miyao M, Abe T
Department of Ophthalmology, Niigata University School of Medicine.
Nihon Rinsho. 1994 Feb;52(2):495-501.
Bacterial endophthalmitis is generally considered to be the most severe and vision-threatening form of ocular infection. It may follow ocular surgery, trauma or microbial keratitis, -exogenous endophthalmitis-, or derived from a blood borne organism-endogenous endophthalmitis. The most common organisms causing exogenous endophthalmitis were gram positive bacteria, including Coagulase negative Staphylococcus, Staphylococcus aureus. Streptococcus pneumoniae and other streptococcal species. On the other hand, endogenous cases were mainly due to gram negative bacteria, including Klebsiella pneumoniae and Escherichia coli. Antimicrobial agents should be chosen based on the usual sensitivity of known or suspected pathogens. Aminoglycosides are almost universally used, combined with cephems and fluoroquinolone topically, subconjunctivally, parenterally and intravitreally. Vancomycin is applied in MRSA infection. In severe cases, vitrectomy with intravitreal antibiotics, corticosteroid are performed most effectively.