Result of early vitrectomy for endogenous Klebsiella pneumoniae endophthalmitis.
OBJECTIVE
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.
Yoon
Young H
YH
Department of Ophthalmology, Asan Medical Center, Seoul, Korea. yhyoon@amc.seoul.kr
Lee
Sang U
SU
Sohn
Joon-Hong
JH
Lee
Song E
SE
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008100:Liver Abscess / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000382:microbiology
D000900:Anti-Bacterial Agents