Clinical Aspect of Bacterial Endogenous Endophthalmitis.

Lee, Seung Joon; Lee, Mi Ae; Kwak, Hyung Woo

Original Article

Journal of the Korean Ophthalmological Society 2000;41(1):112-118.
Published online January 1, 2000.

Clinical Aspect of Bacterial Endogenous Endophthalmitis.

Seung Joon Lee, Mi Ae Lee, Hyung Woo Kwak

Department of Ophthalmology, College of Medicine, Kyunghee University.

세균성 내인성 안내염의 임상적 고찰

이승준(Seung Joon Lee),이미애(Mi Ae Lee),곽형우(Hyung Woo Kwak)

Abstract

Bacterial endogenous endophthalmitis is a rare, but devastating complication of septicemia.It has occurred in the process of systemic infection and its underlying conditions are Diabetes Mellitus, advanced liver disease and immunosuppressive state or drug abuse. Klebsiella endogenous endophthalmitis is especially rapidly progressive and visual outcome is typically poor. To evaluate the clinical aspect of this disease, particularly predisposing factors, causative microorganism, outcome of therapeutic modality and initial time of therapy, we performed a retrospective study on 9 eyes of 9 patients who had been treated with this diagnosis from September 1988 to January 1999 at Kyung-Hee Medical Center. Mean time between the onset of disease and the initiation of therapy was 4.33 days. Underlying systemic diasease consist of Daibetes Mellitus, advanced liver disease and chronic renal failure [5 patients:DM with advanced liver disease, 3 patients:DM alone, 1 patient:DM with CRF].The visual outcome was poor but it turned out better in two patients compared with initial visual acuity, no change in one patient and worse in six patients. We found that Diabetes Mellitus and advanced liver disease were leading underlying predisposing factors of Klebsiella Pneumoniae and visual outcome was poor despite the various intensive treatments.High index of suspicion and aggressive diagnostic and therapeutic approach might improve visual outcome.

Key Words: Diabetes Mellitus;Endogenous endophthalmitis;Klebsiella pneumoniae