Endogenous Klebsiella endophthalmitis associated with Klebsiella pneumoniae pneumonia.
OBJECTIVE
To investigate the management, bacterial strains, antibiotic sensitivities, and visual outcomes in patients with Klebsiella pneumoniae pneumonia and endogenous Klebsiella endophthalmitis.


METHODS
Data were collected for treatments, antibiotic sensitivity patterns, and final visual outcomes.


RESULTS
The study included 10 eyes of 9 patients with a median age of 42 years (range, 0-86 years). Diabetes mellitus was the most common comorbid risk factor (n = 5, 56%). Nine eyes (90%) were treated with intravitreal antibiotics, and one with pars plana vitrectomy and intravitreal antibiotics. One eye achieved a favorable visual acuity of 20/20; however, 6 eyes developed vision of no light perception, including 2 of evisceration. Two nosocomial K. pneumoniae isolates were extended-spectrum-beta-lactamase-producing strains, which demonstrated the resistance to amikacin and ceftazidime.


CONCLUSIONS
Ophthalmologists and physicians should be aware of Klebsiella pneumonia as a possible cause of endogenous endophthalmitis, and endogenous Klebsiella endophthalmitis usually causes poor visual outcomes.
Chen
Kuan-Jen
KJ
Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan. cgr999chiayi@yahoo.com.tw
Hwang
Yih-Shiou
YS
Chen
Yen-Po
YP
Lai
Chi-Chun
CC
Chen
Tun-Lu
TL
Wang
Nan-Kai
NK
D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D007710:Klebsiella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D012307:Risk Factors; D014792:Visual Acuity; D014822:Vitreous Body
D000900:Anti-Bacterial Agents