PURPOSE: 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.
PURPOSE: 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.
Authors: Ammar M Al-Mahmood; Ghada Y Al-Binali; Hind Alkatan; Emad B Abboud; Ahmed M Abu El-Asrar Journal: Int Ophthalmol Date: 2011-01-25 Impact factor: 2.031
Authors: P P Connell; E C O'Neill; D Fabinyi; F M A Islam; R Buttery; M McCombe; R W Essex; E Roufail; B Clark; D Chiu; W Campbell; P Allen Journal: Eye (Lond) Date: 2010-10-22 Impact factor: 3.775
Authors: Michelle C Callegan; Michael S Gilmore; Meredith Gregory; Raniyah T Ramadan; Brandt J Wiskur; Andrea L Moyer; Jonathan J Hunt; Billy D Novosad Journal: Prog Retin Eye Res Date: 2007-01-22 Impact factor: 21.198
Authors: Peijuan Wang; Qianying Gao; Xiaofeng Lin; Shaochong Zhang; Jie Hu; Yaqin Liu; Nuo Xu; Jian Ge Journal: PLoS One Date: 2012-10-01 Impact factor: 3.240