Clinical Aspect of Bacterial Endogenous Endophthalmitis

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

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.