Analysis of the clinical characteristics of Klebsiella pneumoniae endogenous endophthalmitis
10.3760/cma.j.cn431274-20250323-00410
- VernacularTitle:肺炎克雷伯菌性内源性眼内炎的临床特征分析
- Author:
Shi FENG
1
;
Wenfei ZHANG
1
;
Xinyu ZHAO
1
;
Youxin CHEN
1
Author Information
1. 中国医学科学院 北京协和医院眼科，北京 100730
- Publication Type:Journal Article
- Keywords:
Endophthalmitis;
Klebsiella pneumoniae
- From:
Journal of Chinese Physician
2025;27(5):650-653
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To review the clinical characteristics, treatment and prognosis of patients with Klebsiella pneumoniae endogenous endophthalmitis in the past 20 years, in order to guide diagnosis and treatment.Methods:Patients with Klebsiella pneumoniae endogenous endophthalmitis who visited the Ophthalmology Department of Peking Union Medical College Hospital from January 2004 to December 2023 were retrospectively included. The basic information, general condition, microbiological evidence, treatment regimens and prognosis of the patients were statistically analyzed.Results:A total of 26 patients (33 affected eyes) were included, with an age of (53.6±12.6)years. Among them, 76.9%(20/26) of the patients had diabetes mellitus, 61.5%(16/26) of the patients had liver abscess, and 88.5%(23/26) of the patients visited the hospital due to systemic infection symptoms such as fever rather than ocular symptoms. Thirty affected eyes underwent complete ocular sign examinations. The time from the appearance of ocular symptoms to the first ophthalmic visit of the patients was (10.5±6.2)days. The best corrected visual acuity of the minimum resolution visual Angle logarithm (logMAR) of the affected eyes at the visit was (2.3±0.9), and retinal detachment occurred in 70.0%(21/30) of the affected eyes. Thirty-three affected eyes received (2.9±2.3) intravitreal antibiotic injections. 66.7%(22/33) of the affected eyes underwent vitreous surgeries, and 24.2%(8/33) of the affected eyes eventually underwent enucleation of the ocular contents or enucleation of the eyeball. The median follow-up time for the patients was 111 days. The logMAR best corrected visual acuity at the last follow-up was (2.1±0.9), and only 27.3%(9/33) of the affected eyes had improved visual acuity compared with that at the first visit.Conclusions:Klebsiella pneumoniae endogenous endophthalmitis progresses rapidly and has a poor prognosis. The combined systemic and intraocular application of antibiotics and vitreous surgeries are crucial for eye protection. Early diagnosis and early treatment are the most crucial.
