A Case of Klebsiella Endogenous Endophthalmitis Accompanied by Necrotizing Scleral Perforation.

Tae, Kee Sun; Kim, Tae Hwan; Moon, Yeon Sung; Chin, Hee Seung

Case Report

Journal of the Korean Ophthalmological Society 2003;44(11):2680-2686.
Published online November 1, 2003.

A Case of Klebsiella Endogenous Endophthalmitis Accompanied by Necrotizing Scleral Perforation.

Kee Sun Tae, Tae Hwan Kim, Yeon Sung Moon, Hee Seung Chin

Department of Ophthalmology, Inha University College of Medicine, Korea. hschin@inha.ac.kr

괴사성 공막천공이 동반된 Klebsiella내인성 안내염 1예

태기선 ( Tae Gi Seon ) , 김태환 ( Kim Tae Hwan ) , 문연성 ( Mun Yeon Seong ) , 진희승 ( Jin Hui Seung )

Abstract

PURPOSE
We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae, accompanied by orbital cellulitis and necrotizing scleral perforation secondary to liver abscess. METHODS: A fifty three year old woman patient who had received treatment for uveitis in local ophthalmic clinic for five days was referred to this ophthalmologic department in consultation for uncontrolled ocular pain and eyelid swelling accompanied by proptosis. Ten days before admission, she had already received antibiotic medication at internal medicine clinic for abdominal pain and fever. Since her ocular pain along with exophthalmos and eyelid swelling got worse, she received a whole body examination including blood culture, urine test, chest and abdominal radiologic examination to find out infectious focus. In addition, ultrasonography, computed tomography and aqueous culture for ophthalmic examination were performed. Then she was treated with antibiotic medication via systemic and topical route. RESULTS: The Klebsiella pneumoniae was cultured from vitreous in endogenous endophthalmitis accompanied by orbital cellulitis and necrotizing scleral perforation. Although the inflammation was improved with antibiotic medication, she lost her vision. CONCLUSIONS: From the fact that scleral perforation can be complicated by endogenous bacterial endophthalmitis, it is strongly urged that systemic work up such as radiologic examination and blood test be carried out with caution to detect infectious diseases.

Key Words: Endogenous endophthalmitis;Klebsiella pneumoniae;Necrotizing scleral perforation;Uveitis