Endogenous Klebsiella Endophthalmitis Associated with Klebsiella pneumoniae Pneumonia

Abstract

Purpose: To investigate the management, bacterial strains, antibiotic sensitivities, and visual outcomes in patients with Klebsiella pneumoniae pneumonia and endogenous Klebsiella endophthalmitis. Methods: Data were collected for treatments, antibiotic sensitivity patterns, and final visual outcomes. Results: The study included 10 eyes of 9 patients with a median age of 42 years (range, 0–86 years). Diabetes mellitus was the most common comorbid risk factor (n = 5, 56%). Nine eyes (90%) were treated with intravitreal antibiotics, and one with pars plana vitrectomy and intravitreal antibiotics. One eye achieved a favorable visual acuity of 20/20; however, 6 eyes developed vision of no light perception, including 2 of evisceration. Two nosocomial K. pneumoniae isolates were extended-spectrum-β -lactamase-producing strains, which demonstrated the resistance to amikacin and ceftazidime. Conclusions: Ophthalmologists and physicians should be aware of Klebsiella pneumonia as a possible cause of endogenous endophthalmitis, and endogenous Klebsiella endophthalmitis usually causes poor visual outcomes.