Klebsiella pneumoniae endogenous endophthalmitis secondary to liver abscess syndrome

Dear Editor,We report a case of endogenous endophthalmitis(EE)secondary to Klebsiella pneumoniae(KP)liver abscess syndrome.EE is a severe infection of the vitreous cavity that results from the hematogenous spread of microorganism from a remote source into the eye;.     

内源性肺炎克雷伯杆菌性眼内炎的临床分析

目的:分析内源性肺炎克雷伯杆菌性眼内炎(EKPE)患者的临床特征与治疗效果。方法:回顾性分析江苏省苏北人民医院2017年1月至2021年3月EKPE 9例(10眼)的临床资料。所有患者入院后均予经验性抗感染治疗,并查找原发灶。入院后均急诊行玻璃体内抗生素注射术,8眼行玻璃体切除术。收集术眼的房水及玻璃体进行微生物培养。...     

Result of early vitrectomy for endogenous Klebsiella pneumoniae endophthalmitis

PURPOSE: To determine the role of pars plana vitrectomy (PPV) in the treatment of Klebsiella pneumoniae endogenous endophthalmitis. METHODS: Records of seven consecutive patients (10 eyes) diagnosed with Klebsiella endogenous endophthalmitis were retrospectively reviewed. RESULTS: Five patients (71%) had diabetes, and four (57%) had a liver abscess as the source. In most cases, the inflammation progressed within days and resulted in decreased vision worse than hand motions and a total vitreous abscess, despite systemic and intravitreal antibiotic injections. A PPV with subretinal abscess drainage and silicone oil tamponade was performed within 2 weeks. After 6 months, the retina remained attached in all eyes (100%), and vision was counting fingers or better in five eyes (50%). Two eyes recovered visual acuity between 20/63 and 20/125. CONCLUSIONS: Physicians should be alerted to the development of endogenous endophthalmitis in patients with Klebsiella septicemia, especially in diabetics with a hepatobiliary abscess. Aggressive therapy, including early vitrectomy with antibiotic injection, may improve the final outcome in this otherwise devastating ocular condition.     

A lack of ongoing diabetes is an important factor in preserving eyes from late or suboptimally treated endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess

Purpose:

The purpose of this study is to identify the possible factors for preserving the eyes after late or suboptimally treated endogenous endophthalmitis secondary to Klebsiella pneumoniae (KP) liver abscess.

Methods:

A retrospective chart review was conducted for patients admitted with KP liver abscess from January 1991 to June 2012.

Results:

Six hundred and ninety-three patients with KP liver abscess were recorded, in which endophthalmitis was identified in 53 cases (65 eyes, 8.29%). Diabetes was significantly associated with the development of endophthalmitis (p = 0.014). Eleven eyes received their last ocular treatment ≥10 days and final vision ≥ counting fingers, and were defined as benign type KP endophthalmitis. The absence of diabetes was the only consistent candidate factor for benign type KP endophthalmitis.

Conclusion:

A lack of ongoing diabetes is an important factor in preserving eyes with late or suboptimally treated endogenous endophthalmitis second to KP liver abscess.     

Clinical characteristics of endogenous Klebsiella pneumoniae endophthalmitis: a 13-year experience

International Ophthalmology - This study aimed to investigate the clinical features and risk factors for poor visual outcomes in patients with endogenous Klebsiella pneumoniae endophthalmitis...     

Long-term follow-up of bilateral endogenous Klebsiella endophthalmitis

BACKGROUND: Endophthalmitis subsequent to Klebsiella sepsis leads to functional blindness in most cases and is very difficult to treat. Every successful therapeutic modality can therefore help in creating an optimal therapeutic plan. CASE REPORT: A 69-year old diabetic patient exhibited bilateral Klebsiella endophthalmitis with sepsis after a pneumonia. Two intravenous antibiotics were used: aminoglycosides (Gentamycin) and cephalosporins (Cefotaxim or Cefuroxim) with local parabulbar injections of Prednisolon. The long-term follow-up of four years provided some overview of morphological aspects of the development of endophthalmitis. Characteristic greyish hypopyon was seen in both eyes, which was more pronounced in the left eye than in the right. The left eye became phthisic. After resorption of the hypopyon in the right eye and prolonged resorption of the subretinal abscess for 9 months a useful visual acuity at 0.2 was achieved. Two years after the endophthalmitis a cataract surgery with implantation of a posterior chamber silicon lens was performed and good visual acuity (0.6) was achieved. After four years, the subretinal abscess left an extremely large, sharp bordered, unpigmented scar up to the sclera. CONCLUSION: An early diagnosis and adequate long-time antibiotic therapy under the co-operative supervision of an ophthalmologist with internist appears to be most important for the therapeutic success in Klebsiella endophthalmitis.     

Endogenous Klebsiella pneumoniae endophthalmitis in diabetic patients.

We describe 12 patients with endogenous endophthalmitis caused by Klebsiella pneumoniae seen between 1983 and 1988. Three patients had bilateral involvement. Eleven patients had diabetes mellitus, either newly diagnosed or poorly controlled. In six cases the infection was associated with a liver abscess. In all eyes the outcome was light perception or worse; nine eyes had no light perception. Six eyes were enucleated or eviscerated.