A 10-year comparison of endogenous endophthalmitis outcomes: an east Asian experience with Klebsiella pneumoniae infection.
OBJECTIVE
To evaluate the infection sources and causative organisms in cases of endogenous endophthalmitis and review the outcomes for patients with Klebsiella pneumoniae infection during a 10-year period.


METHODS
All cases of endogenous endophthalmitis treated at one Taiwanese hospital from July 1992 to June 2002 were retrospectively reviewed (n = 74; 86 eyes). The study was divided into two 5-year periods, with patients stratified into Group F or Group L according to onset date within the first or last of these periods, respectively. The outcomes of cases of K. pneumoniae infection in Group L (21 eyes) and Group F (32 eyes) were compared.


RESULTS
The major source of infection (liver abscess) and the causative organism (K. pneumoniae) did not change throughout the 10-year review period; however, outcomes for Group L appeared superior. The interval from onset of ocular symptoms to ophthalmic consultation was shorter for Group L; however, a statistically significant difference was not demonstrated by between-group comparison. Patients with good final vision typically had good initial vision in cases of K. pneumoniae infection.


CONCLUSIONS
The authors' experience with endogenous endophthalmitis has confirmed the findings of analogous East Asian studies, with liver abscess as the major source of infection and K. pneumoniae as the causative organism. Superior outcome may be achieved with more comprehensive and collaborative management, ideally through the combined efforts of multiple medical subspecialties.
Chen
Yung-Jen
YJ
Department of Ophthalmology, Chang Gung Memorial Hospital, Kaohsiung Hsien, Taiwan. d2767@adm.cgmh.org.tw
Kuo
Hsi-Kung
HK
Wu
Pei-Chang
PC
Kuo
Min-Lun
ML
Tsai
Hsih-Hao
HH
Liu
Chi-Chang
CC
Chen
Chih-Hsin
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D009877:Endophthalmitis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008100:Liver Abscess / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology
D000900:Anti-Bacterial Agents