Endophthalmitis caused by Klebsiella species

Jayanth Sridhar, Harry W. Flynn, Ajay E. Kuriyan, Sander Dubovy, Darlene Miller

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1875-1881
Number of pages7
JournalRetina
Volume34
Issue number9
DOIs
StatePublished - Sep 2014

Keywords

  • Bacterial eye infections
  • Endogenous
  • Endophthalmitis
  • Klebsiella

ASJC Scopus subject areas

  • Ophthalmology

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