Capucine Odouard1,2, Daini Ong3,4, Parth R Shah2, Thomas Gin4,5, Penelope J Allen3,4, John Downie1,2, Lyndell L Lim3,4,5, Peter McCluskey1,2,6. 1. Sydney Hospital and Sydney Eye Hospital, Sydney, New South Wales, Australia. 2. Prince of Wales Hospital, Randwick, New South Wales, Australia. 3. Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia. 4. Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. 5. Royal Melbourne Hospital, Parkville, Victoria, Australia. 6. Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.
Abstract
BACKGROUND: Endogenous Klebsiella pneumoniae endophthalmitis (EKPE) is a well-known entity in South-East Asia. We demonstrate a range of differing clinical features and outcomes of EKPE, and highlight the increasing incidence of EKPE in major centres in Sydney and Melbourne, Australia. DESIGN: Retrospective observational case study and case series in the hospital setting. PARTICIPANTS: Four cases of EKPE. METHODS: EKPE cases from 2005 to 2015 were identified through established endophthalmitis databases as well as hospital-based microbiological searches. MAIN OUTCOME MEASURES: EKPE cases were confirmed with positive K. pneumoniae intraocular samples. RESULTS: Rising trends of EKPE were noted in major centres in Australia. Six eyes of four patients with EKPE from January 2011 to December 2015 are reported. The mean age was 49 years (range 43-58 years). Two patients had bilateral involvement. There were systemic symptoms up to 10 days prior to ocular symptoms. The source of sepsis in all cases was a hepatic abscess. Two patients had diabetes mellitus. Five eyes had hypopyon panuveitis on presentation. All eyes underwent vitrectomy. The patient with the most delayed presentation underwent enucleation following globe perforation. Final best corrected visual acuity (BCVA) in one patient with bilateral EKPE was light perception (LP) only. The other three eyes had BCVA in at least one eye of 6/24 or better. CONCLUSIONS: EKPE is an emerging condition in Australia. Although rare, EKPE is a sight-threatening and potentially life-threatening emergency that can initially present to ophthalmologists. One should suspect EKPE in septic patients with a B-scan showing a vitreous or retinal abscess.
BACKGROUND: Endogenous Klebsiella pneumoniae endophthalmitis (EKPE) is a well-known entity in South-East Asia. We demonstrate a range of differing clinical features and outcomes of EKPE, and highlight the increasing incidence of EKPE in major centres in Sydney and Melbourne, Australia. DESIGN: Retrospective observational case study and case series in the hospital setting. PARTICIPANTS: Four cases of EKPE. METHODS: EKPE cases from 2005 to 2015 were identified through established endophthalmitis databases as well as hospital-based microbiological searches. MAIN OUTCOME MEASURES: EKPE cases were confirmed with positive K. pneumoniae intraocular samples. RESULTS: Rising trends of EKPE were noted in major centres in Australia. Six eyes of four patients with EKPE from January 2011 to December 2015 are reported. The mean age was 49 years (range 43-58 years). Two patients had bilateral involvement. There were systemic symptoms up to 10 days prior to ocular symptoms. The source of sepsis in all cases was a hepatic abscess. Two patients had diabetes mellitus. Five eyes had hypopyon panuveitis on presentation. All eyes underwent vitrectomy. The patient with the most delayed presentation underwent enucleation following globe perforation. Final best corrected visual acuity (BCVA) in one patient with bilateral EKPE was light perception (LP) only. The other three eyes had BCVA in at least one eye of 6/24 or better. CONCLUSIONS: EKPE is an emerging condition in Australia. Although rare, EKPE is a sight-threatening and potentially life-threatening emergency that can initially present to ophthalmologists. One should suspect EKPE in septicpatients with a B-scan showing a vitreous or retinal abscess.
Authors: Chun Yue Mak; Mary Ho; Lawrence Pui-Leung Iu; Helena Pui-Yee Sin; Li Jia Chen; Grace Lui; Marten Erik Brelen; Alvin Lerrmann Young Journal: Int J Ophthalmol Date: 2020-12-18 Impact factor: 1.779
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