Endogenous Klebsiella endophthalmitis. Report of two cases and review of the literature

Ophthalmology. 1994 Jul;101(7):1298-301. doi: 10.1016/s0161-6420(94)31176-6.

Abstract

Background: Endogenous endophthalmitis is a rare complication of gram-negative sepsis. The diagnosis often is delayed unless a high index of suspicion exists. Familiarity with the clinical setting in which endogenous Klebsiella endophthalmitis occurs will hasten diagnosis and may improve outcome.

Methods: The authors reviewed the medical literature and describe two patients with diabetes who lost vision from endogenous Klebsiella endophthalmitis.

Findings: One patient lost all vision in both eyes before the diagnosis of sepsis was clinically suspected. In the other, endophthalmitis was the only clinical sign of septicemia 8 days after hospital discharge for treatment of a Klebsiella urinary tract infection. Survey of the literature showed an increase in the number of cases of endogenous Klebsiella endophthalmitis reported over the last 12 years. Sixty-one percent of the 44 patients reported in the literature since 1981 had diabetes, 68% had suppurative liver disease, and 16% had urinary tract infection.

Conclusion: An important implication of these associations is that metastatic Klebsiella endophthalmitis must be considered when vitritis occurs in patients with diabetes, particularly in those with acute liver disease or a urinary tract infection, or in any patient with vitritis and suppurative liver disease.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis
  • Blindness / microbiology
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Enucleation
  • Eye Infections, Bacterial*
  • Female
  • Humans
  • Klebsiella Infections*
  • Klebsiella pneumoniae / isolation & purification*

Substances

  • Anti-Bacterial Agents