J Korean Ophthalmol Soc.  2019 Sep;60(9):851-858. 10.3341/jkos.2019.60.9.851.

Clinical Characteristics and Prognosis of Endogenous Endophthalmitis in Western Gyeongsangnam-do

Affiliations
  • 1Department of Ophthalmology, Gyeongsang National University College of Medicine, Jinju, Korea. in0chung@hanmail.net
  • 2Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea.
  • 3Institute of Health Sciences, Gyeongsang National University, Jinju, Korea.

Abstract

PURPOSE
To investigate the clinical features and prognosis associated with endogenous endophthalmitis (EE) in western Gyeongsangnam-do over an 11-year period.
METHODS
This study was a retrospective review of the medical records of 24 patients (33 eyes) who presented with endogenous endophthalmitis at the Gyeongsang National University Hospital from 2007 to 2017.
RESULTS
The mean age of onset was 63.2 years, and 58.3% of the patients were men. Bilateral involvement was observed in nine patients (37.5%). Liver abscess (30.3%) and urinary tract infection (24.2%) were the most common extraocular sources of infection. Positive culture result was noted in 72.7% of the patients. The most common causative agents were gram-negative organisms (45.8%); the most commonly isolated microorganism was Klebsiella pneumoniae. Vitreous tapping and intravitreal antibiotic injection were performed in all patients; pars plana vitrectomy with intravitreal injection of antibiotics was performed in 12 eyes (36.4%). Enucleation and evisceration were performed in six eyes (18.2%). Initial visual acuity worse than hand motion was associated with a significantly worse visual outcome (p = 0.001).
CONCLUSIONS
In our study, EE showed a poor visual prognosis, irrespective of treatment. Poor initial visual acuity was predictive of poor visual outcome. Liver abscess and urinary tract infections were common extraocular sources of EE and K. pneumoniae was the most common causative organism.

Keyword

Endophthalmitis; Klebsiella; Prognosis; Liver abscess

MeSH Terms

Age of Onset
Anti-Bacterial Agents
Endophthalmitis*
Gyeongsangnam-do*
Hand
Humans
Intravitreal Injections
Klebsiella
Klebsiella pneumoniae
Liver Abscess
Male
Medical Records
Pneumonia
Prognosis*
Retrospective Studies
Urinary Tract Infections
Visual Acuity
Vitrectomy
Anti-Bacterial Agents

Figure

  • Figure 1 Identifiable associated systemic factors of patients with endogenous endophthalmitis. Diabetes is the leading systemic factor following cancer, chronic kidney disease and liver cirrhosis.

  • Figure 2 Identifiable presumed infection source of patients with endogenous endophthalmitis. Note that liver abscess is the leading cause of presumed infection source.


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