Medscape is available in 5 Language Editions – Choose your Edition here.


Ophthalmologic Manifestations of Escherichia Coli Workup

  • Author: Donny W Suh, MD, FAAP; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Feb 05, 2016

Laboratory Studies

The following studies are indicated in patients with suspected E coli infection:

  • CBC count with cell differentials
  • Blood agar
  • Sabouraud dextrose agar without cycloheximide
  • Thioglycolate broth
  • Chocolate agar
  • Löwenstein-Jensen medium
  • Nonnutrient agar with E coli overlay
  • Slides - Gram stain, Giemsa stain

Imaging Studies

CT scanning of the orbit and head may be helpful in case of trauma to look for a foreign body.



With a corneal ulcer, anesthetize the cornea with topical drops, and, at the slit lamp, scrape the base and the leading edge of the infiltrate with the Kimura spatula, and place on the culture medium or slide.

With endophthalmitis, diagnostic and therapeutic vitrectomy is used to confirm the diagnosis and to evaluate the organisms' sensitivity to antibacterial agents.


Histologic Findings

E coli is a gram-negative rod. E coli has a fermentative and respiratory type of metabolism.

Contributor Information and Disclosures

Donny W Suh, MD, FAAP Chief of Pediatric Ophthalmology and Strabismus, Children's Hospital and Medical Center; Associate Professor, Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center

Donny W Suh, MD, FAAP is a member of the following medical societies: American Academy of Ophthalmology, American Academy of Pediatrics, American Association for Pediatric Ophthalmology and Strabismus, American Medical Association, Iowa Medical Society, National Eye Care Project

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Sigma Xi, Southern Medical Association, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Kilbourn Gordon, III, MD, FACEP Urgent Care Physician

Kilbourn Gordon, III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology, Wilderness Medical Society

Disclosure: Nothing to disclose.

  1. Chen CJ, Starr CE. Epidemiology of gram-negative conjunctivitis in neonatal intensive care unit patients. Am J Ophthalmol. 2008 Jun. 145(6):966-970. [Medline].

  2. Raju B, Bali T, Thiagarajan G, Rao V, Das T, Sharma S. Physicochemical properties and antibacterial activity of the precipitate of vancomycin and ceftazidime: implications in the management of endophthalmitis. Retina. 2008 Feb. 28(2):320-5. [Medline].

  3. Amini E, Ghasemi M, Daneshjou K. A five-year study in Iran of ophthalmia neonatorum: prevalence and etiology. Med Sci Monit. 2008 Feb. 14(2):CR90-96. [Medline].

  4. Aronson SB, Elliott JH. Ocular Inflammation. St. Louis, MO: CV Mosby; 1972. 103-5, 112-4.

  5. Balestrazzi A, Blasi MA, Primitivo S, Balestrazzi E. Escherichia coli endophthalmitis after trans-scleral resection of uveal melanoma. Eur J Ophthalmol. 2002 Sep-Oct. 12(5):437-9. [Medline].

  6. Bonadio WA, Smith DS, Madagame E, et al. Escherichia coli bacteremia in children. A review of 91 cases in 10 years. Am J Dis Child. 1991 Jun. 145(6):671-4. [Medline].

  7. Charoo NA, Kohli K, Ali A, Anwer A. Ophthalmic delivery of ciprofloxacin hydrochloride from different polymer formulations: in vitro and in vivo studies. Drug Dev Ind Pharm. 2003 Feb. 29(2):215-21. [Medline].

  8. Cordido M, Fernandez-Vigo J, Cordido F, Rey AD. Bilateral metastatic endophthalmitis in diabetics. Acta Ophthalmol (Copenh). 1991 Apr. 69(2):266-7. [Medline].

  9. Eisenstein BI. Escherichia coli infections. Harrison's Principles of Internal Medicine. 1994. 661-3.

  10. Epstein SP, Bottone EJ, Asbell PA. Susceptibility testing of clinical isolates of pseudomonas aeruginosa to levofloxacin, moxifloxacin, and gatifloxacin as a guide to treating pseudomonas ocular infections. Eye Contact Lens. 2006 Sep. 32(5):240-4. [Medline].

  11. Fanning WL, Stubbert J, Irwin ES, Aronson MD. A case of bilateral Escherichia coli endogenous endophthalmitis. Am J Med. 1976 Aug. 61(2):295-7. [Medline].

  12. Faraawi R, Fong IW. Escherichia coli emphysematous endophthalmitis and pyelonephritis. Case report and review of the literature. Am J Med. 1988 Mar. 84(3 Pt 2):636-9. [Medline].

  13. Glasser DB, Baum J. Antibacterial agents. Infections of the Eye. 1996. 207-30.

  14. Hyndiuk RA, Cokington CD. Bacterial keratitis. Infections of the Eye. 1996. 323-47.

  15. Katz HR. A retrospective study of endophthalmitis rates comparing quinolone antibiotics. Am J Ophthalmol. 2005 Oct. 140(4):771-2; author reply 772-3. [Medline].

  16. Ko KS, Lee MY, Song JH, et al. Prevalence and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae isolated in Korean hospitals. Diagn Microbiol Infect Dis. 2008 Aug. 61(4):453-9. [Medline].

  17. Munoz Morente A, Baron Ramos MA, Mateos Fernandez S, Reguera Iglesias JM. Endogenous bacterial endophthalmitis: a case report and brief review [in Spanish]. An Med Interna. 2004 Dec. 21(12):597-8. [Medline].

  18. Park SB, Searl SS, Aquavella JV, Erdey RA. Endogenous endophthalmitis caused by Escherichia coli. Ann Ophthalmol. 1993 Mar. 25(3):95-9. [Medline].

  19. Regnier A, Schneider M, Concordet D, Toutain PL. Intraocular pharmacokinetics of intravenously administered marbofloxacin in rabbits with experimentally induced acute endophthalmitis. Am J Vet Res. 2008 Mar. 69(3):410-5. [Medline].

  20. Sanford JP, Gilbert DN, Sande MA. Antimicrobial. Guide to Antimicrobial Therapy. 1997. 47.

  21. Sekimoto M, Hayasaka S, Setogawa T, Shigeno K. Endogenous Escherichia coli endophthalmitis in a patient with autosomal-dominant polycystic kidney disease. Ann Ophthalmol. 1991 Dec. 23(12):458-9. [Medline].

  22. Shammas HF. Endogenous E. coli endophthalmitis. Surv Ophthalmol. 1977 Mar-Apr. 21(5):429-35. [Medline].

  23. Sim DA, Feasey N, Wren S, Breathnach A, Thompson G. Cross-infection risk of felt-tipped marker pens in cataract surgery. Eye. 2008 Jul 11. [Medline].

  24. Starr MB. A retrospective study of endophthalmitis rates comparing quinolone antibiotics. Am J Ophthalmol. 2005 Oct. 140(4):769-70; author reply 770-1. [Medline].

  25. Sunakawa K, Nonoyama M, Ooishi T, et al. The trend of childhood bacterial meningitis in Japan (2000-2002) [in Japanese]. Kansenshogaku Zasshi. 2004 Oct. 78(10):879-90. [Medline].

  26. Tseng CY, Liu PY, Shi ZY, et al. Endogenous endophthalmitis due to Escherichia coli: case report and review. Clin Infect Dis. 1996 Jun. 22(6):1107-8. [Medline].

  27. Turck M, Schaberg D. Infections due to enterobacteriaceae. Harrison's Principles of Internal Medicine. 1980. 629-34.

  28. Walmsley RS, David DB, Allan RN, Kirkby GR. Bilateral endogenous Escherichia coli endophthalmitis: a devastating complication in an insulin-dependent diabetic. Postgrad Med J. 1996 Jun. 72(848):361-3. [Medline].

  29. Wann SR, Liu YC, Yen MY, et al. Endogenous Escherichia coli endophthalmitis. J Formos Med Assoc. 1996 Jan. 95(1):56-60. [Medline].

  30. Zhang YQ, Wang WJ. Treatment outcomes after pars plana vitrectomy for endogenous endophthalmitis. Retina. 2005 Sep. 25(6):746-50. [Medline].

Bacterial corneal ulcer with hypopyon.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.