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Jayanth Sridhar, Harry W Flynn, Ajay Eapen Kuriyan, Sander R Dubovy, Darlene Miller; Endophthalmitis caused by Klebsiella species. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3856.
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To report the clinical presentation, antibiotic sensitivities, treatment strategies, and visual outcomes associated with endophthalmitis caused by Klebsiella species.
A non-comparative 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.
Seven patients were identified. Clinical settings included endogenous (n=3), post-traumatic (n=2), trabeculectomy bleb-associated (n=1), and post-penetrating keratoplasty (n=1). Five patients presented with hypopyon. Presenting visual acuity ranged from 20/60 to light perception in non-endogenous cases and 1/200 to light perception in endogenous cases. Klebsiella was sensitive to aminoglycosides, 3rd generation cephalosporins, and 2nd and 3rd 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 non-endogenous cases, final visual acuity was 20/70 or better in all four patients.
Endophthalmitis caused by Klebsiella species is associated with poor visual outcomes. Endogenous cases had high rates of enucleation or evisceration.
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