Martel A, Butet B, Ramel J C, Martiano D, Baillif S
Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, avenue Voie-Romaine, 06000 Nice, France.
Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, avenue Voie-Romaine, 06000 Nice, France.
J Fr Ophtalmol. 2017 Dec;40(10):876-881. doi: 10.1016/j.jfo.2017.06.007. Epub 2017 Nov 20.
To report the case of a Klebsiella pneumoniae endogenous endophthalmitis (KPEE) of hepatic and urinary origin that was successfully treated with systemic antibiotherapy and 13 intravitreal antibiotics injections without performing a vitrectomy.
Case report of a 60-year-old man with a subretinal abscess in the left eye that developed 3 days after initial presentation for K. pneumoniae bacteremia, liver abscess and urinary tract infection.
Ophthalmic examination of the left eye showed anterior uveitis and a single subretinal abscess located in mid-peripheral temporal retina. BCVA dropped to 20/50. Follow-up was made with clinical examination and multimodal imaging (SD-OCT, FA, ICGA) with high field photographs. A total of 13 intravitreal injections (IVI) of ceftazidime were performed, and no vitrectomy was required. Ocular signs regressed and prognosis was excellent with 20/20 of final BCVA.
KPEE is a rare but severe condition with a typically poor ocular prognosis. When diagnosis is made early, subretinal abscess with partially conserved BCVA could be treated successfully with medical management that includes systemic antibiotics and repeated intravitreal injections without requiring vitrectomy.
报告一例源于肝脏和泌尿系统的肺炎克雷伯菌内源性眼内炎（KPEE），经全身抗生素治疗及13次玻璃体内抗生素注射成功治愈，未行玻璃体切除术。
病例报告，一名60岁男性，左眼视网膜下脓肿，在初次出现肺炎克雷伯菌血症、肝脓肿和尿路感染3天后发病。
左眼眼科检查显示前葡萄膜炎，单个视网膜下脓肿位于颞侧视网膜中外周。最佳矫正视力（BCVA）降至20/50。通过临床检查和多模式成像（SD-OCT、荧光素血管造影、吲哚菁绿血管造影）及高分辨率照片进行随访。共进行了13次头孢他啶玻璃体内注射（IVI），无需行玻璃体切除术。眼部体征消退，最终BCVA为20/20，预后良好。
KPEE是一种罕见但严重的疾病，眼部预后通常较差。早期诊断时，对于部分保留BCVA的视网膜下脓肿，可通过包括全身抗生素和重复玻璃体内注射在内的药物治疗成功治愈，无需行玻璃体切除术。
