Endogenous Endophthalmitis Caused by <b><i>Klebsiella pneumoniae</i></b>: A Ten-Year Retrospective Study in Western China

Abstract

The aim of this study was to analyse the clinical features, microbiology results, management and outcomes of patients with endogenous endophthalmitis caused by Klebsiella pneumoniae in western China. Methods: A retrospective review of medical records of 10 eyes in 10 subjects diagnosed with endogenous K. pneumoniae endophthalmitis from January 2008 to December 2018 was undertaken. Results: The top 3 predisposing medical conditions included diabetes mellitus (50%), malignancy (20%) and cardiac stent implantation (10%). Extraocular infective foci were mainly found in the liver (40%), lungs (20%) and kidneys (10%). The positive culture rate was 85.71% (6/7) in vitreous samples, 83.33% (5/6) in blood samples and 100% (4/4) in body fluid samples. Only 20% of the patients, who had good initial visual acuity (VA) better than hand movement (HM), achieved a final VA better than 1.0 (log MAR). The mortality rate was 10%. Conclusions: Though the prognosis of endogenous K. pneumoniae endophthalmitis is often poor, patients with an initial VA better than HM may have a good prognosis under comprehensive treatments, including vitrectomy, systemic sensitive antibiotic injection and drainage of the primary infection loci.

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

“…Recent studies have shown that endophthalmitis caused by liver abscess accounts for an increasing percentage of endogenous endophthalmitis cases each year, particularly in East Asia [12]. A study on endogenous endophthalmitis conducted in Korea showed that 25% of primary lesions were liver abscesses [13], whereas a study in Taiwan found that 53% of primary lesions were liver abscesses, and 61% of cases were caused by Klebsiella pneumoniae, and showed the trend of drug resistance [14].…”

Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

“…Recent studies have shown that endophthalmitis caused by liver abscess accounts for an increasing percentage of endogenous endophthalmitis cases each year, particularly in East Asia. 12 A study on endogenous endophthalmitis conducted in Korea showed that 25% of primary lesions were liver abscesses, 13 whereas a study in Taiwan found that 53% of primary lesions were liver abscesses, and 61% of cases were caused by Klebsiella pneumoniae, and showed the trend of drug resistance. 14 In the present study, microbial cultures of the vitreous humor, as well as blood cultures were obtained from all patients.…”

Case Series on Endogenous Klebsiella pneumoniae Endophthalmitis: More Than Meets the Eye

“…Endogenous endophthalmitis (EE) is a rare but potentially sight-threatening disease with an appreciable mortality rate [ 1 - 2 ]. It is a sequel of hematogenous spread from a distant source that breaches the blood ocular barrier causing infection of the intraocular tissue [ 2 ].…”

“…Endogenous endophthalmitis (EE) is a rare but potentially sight-threatening disease with an appreciable mortality rate [ 1 - 2 ]. It is a sequel of hematogenous spread from a distant source that breaches the blood ocular barrier causing infection of the intraocular tissue [ 2 ]. A gram-negative organism, particularly Klebsiella pneumoniae, is the most common causative organism for EE among the Asian population, particularly the East Asians [ 2 - 3 ].…”

“…It is a sequel of hematogenous spread from a distant source that breaches the blood ocular barrier causing infection of the intraocular tissue [ 2 ]. A gram-negative organism, particularly Klebsiella pneumoniae, is the most common causative organism for EE among the Asian population, particularly the East Asians [ 2 - 3 ]. Endogenous Klebsiella pneumoniae endophthalmitis (EKE) usually has a poor final visual outcome despite treatment with intravitreal and systemic antibiotics [ 4 - 5 ].…”