title: Endophthalmitis caused by Klebsiella species.
abstract: OBJECTIVE
  To report the clinical presentation, antibiotic sensitivities, treatment strategies, and visual outcomes associated with endophthalmitis caused by Klebsiella species.
  
  
  METHODS
  A noncomparative consecutive case series. Microbiology database records were retrospectively reviewed for all patients with endophthalmitis caused by Klebsiella species from 1990 to 2012 at a large university referral center. The corresponding clinical records were then reviewed to evaluate the endophthalmitis clinical features and treatment outcomes.
  
  
  RESULTS
  Seven patients were identified. Clinical settings included endogenous (n = 3), posttraumatic (n = 2), trabeculectomy bleb-associated (n = 1), and postpenetrating keratoplasty (n = 1). Five patients presented with hypopyon. Presenting visual acuity ranged from 20/60 to light perception in nonendogenous cases and 1/200 to light perception in endogenous cases. Klebsiella was sensitive to aminoglycosides, third-generation cephalosporins, and second- and third-generation fluoroquinolones in all cases. Initial treatment strategies were vitreous tap and injection (n = 4), pars plana vitrectomy with intravitreal antibiotics (n = 2), and anterior chamber tap and injection (n = 1). All three endogenous cases later underwent enucleation or evisceration. In nonendogenous cases, the final visual acuity was 20/70 or better in all 4 patients.
  
  
  CONCLUSIONS
  Endophthalmitis caused by Klebsiella species is associated with poor visual outcomes. Endogenous cases had high rates of enucleation or evisceration.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: Jayanth
authors.initials: J
authors.lastname: Sridhar
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.forename: Ajay E
authors.initials: AE
authors.lastname: Kuriyan
authors.forename: Sander
authors.initials: S
authors.lastname: Dubovy
authors.forename: Darlene
authors.initials: D
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D007709:Klebsiella / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents