Liao S B, Yang K J, Lai C C, Chen T L, Lee S C
Department of Opthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Chang Gung Med J. 2000 Sep;23(9):566-71.
Endogenous endophthalmitis is a rare but devastating complication of bacteremia. Klebsiella pneumoniae is reported to be the leading organism of endogenous endophthalmitis in Taiwan, and the prognosis of endogenous Klebsiella pneumoniae endophthalmitis is extremely poor. A 46-year-old male patient was hospitalized because of fever, chills, and consciousness disturbance for 1 day. Meningitis was the impression by clinical presentation and findings of cerebrospinal fluid analysis. Parenteral ceftriaxone (4 g/day) and gentamicin (180 mg/day) were given, and his consciousness gradually cleared. On hospital day 6, he complained of blurred vision in both eyes and floaters in the left eye for 1 day. After ophthalmic examination, bilateral endogenous endophthalmitis was diagnosed. After aggressive treatment with intravitreal antibiotics and trans pars plana vitrectomy, the visual outcome of both eyes was better than those of other reported cases.
内源性眼内炎是菌血症罕见但极具破坏性的并发症。据报道，肺炎克雷伯菌是台湾地区内源性眼内炎的主要致病菌，内源性肺炎克雷伯菌性眼内炎的预后极差。一名46岁男性患者因发热、寒战及意识障碍1天入院。根据临床表现及脑脊液分析结果，考虑为脑膜炎。给予静脉注射头孢曲松（4g/天）和庆大霉素（180mg/天），患者意识逐渐清醒。住院第6天，患者诉双眼视物模糊及左眼有飞蚊症1天。眼科检查后，诊断为双侧内源性眼内炎。经玻璃体内注射抗生素及经睫状体平坦部玻璃体切割术积极治疗后，双眼视力预后优于其他报道病例。
