Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, Japan.
J Infect Chemother. 2013 Apr;19(2):326-9. doi: 10.1007/s10156-012-0468-6. Epub 2012 Sep 20.
We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae in an immunocompetent patient. A 73-year-old man with acute epididymitis who had no history of diabetes mellitus developed endogenous endophthalmitis. The patient underwent anterior vitrectomy and intracapsular cataract extraction with intravitreal injections of both vancomycin and ceftazidime. After the surgery, he was treated with topical and intravenous antibiotics; however, the left eye perforated and was enucleated. Culture from vitreous biopsy specimens grew as K. pneumoniae, which was positive for both magA and rmpA. K. pneumoniae should be considered as a pathogen that can cause severe endogenous endophthalmitis in patients with urinary tract infection. The severity of the disease may be related to the virulence genes.
我们报告了一例免疫功能正常的患者由肺炎克雷伯菌引起的内源性眼内炎。一名 73 岁的男性患者患有急性附睾炎,无糖尿病史,发生了内源性眼内炎。患者接受了前玻璃体切除术和囊内白内障摘除术,并在玻璃体内注射了万古霉素和头孢他啶。手术后,他接受了局部和静脉注射抗生素治疗;然而,左眼穿孔并被眼球摘除。玻璃体活检标本的培养结果为肺炎克雷伯菌,magA 和 rmpA 均为阳性。肺炎克雷伯菌应被视为引起尿路感染患者严重内源性眼内炎的病原体。疾病的严重程度可能与毒力基因有关。