PURPOSE: 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. CONCLUSION: Endophthalmitis caused by Klebsiella species is associated with poor visual outcomes. Endogenous cases had high rates of enucleation or evisceration.
PURPOSE: 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. CONCLUSION:Endophthalmitis caused by Klebsiella species is associated with poor visual outcomes. Endogenous cases had high rates of enucleation or evisceration.
Authors: Daniel Dodson; Richard Stewart; Zeynel Karcioglu; Mandi D Conway; David Mushatt; Ramesh S Ayyala Journal: Ophthalmic Surg Lasers Imaging Date: 2009 Sep-Oct
Authors: Vivian Schiedler; Ingrid U Scott; Harry W Flynn; Janet L Davis; Matthew S Benz; Darlene Miller Journal: Am J Ophthalmol Date: 2004-04 Impact factor: 5.258
Authors: Darpun D Sachdev; Michael T Yin; Jason D Horowitz; Sri Krishna Mukkamala; Song Eun Lee; Adam J Ratner Journal: J Clin Microbiol Date: 2013-01-09 Impact factor: 5.948
Authors: Ji Hwan Lee; Hee Suk Kim; Suk Ho Byeon; Sung Soo Kim; Hyoung Jun Koh; Sung Chul Lee; Christopher Seungkyu Lee Journal: Int Ophthalmol Date: 2022-04-17 Impact factor: 2.029