Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ocul Immunol Inflamm. 2020 Apr 2;28(3):468-470. doi: 10.1080/09273948.2019.1569695. Epub 2019 Feb 26.
: Klebsiella endogenous endophthalmitis (EE) is commonly seen in patients with hepato-biliary disease and urinary tract infections. Subretinal abscess with vitreous cells is the usual presentation and requires intensive treatment with systemic and intravitreal antibiotics along with prompt vitrectomy. Subretinal hemorrhage surrounding a choroidal mass has not been reported as the presenting feature of endogenous bacterial endophthalmitis.: We report a patient with chronic liver disease who developed EE secondary to urinary tract infection that mimicked a choroidal neovascular membrane (CNVM) with subretinal bleed.: Klebsiella EE was successfully managed with multiple intravenous and intravitreal injections of piperacillin/tazobactum, without the need for vitrectomy.: In patients with coagulopathy due to liver disease, EE may present with submacular hemorrhage mimicking a CNVM. Clinicians must be cognizant of this fact as delay in instituting appropriate antibiotic therapy can lead to loss of the eye.
: 内源性眼内炎(EE)通常见于肝胆疾病和尿路感染患者。通常表现为视网膜下脓肿伴玻璃体细胞,需要全身和玻璃体内抗生素联合及时玻璃体切除术进行强化治疗。脉络膜肿块周围的视网膜下出血尚未被报道为内源性细菌性眼内炎的表现特征。: 我们报告了一例慢性肝病患者,由于尿路感染继发 EE,其表现类似于伴有视网膜下出血的脉络膜新生血管膜(CNVM)。: 该患者通过多次静脉和玻璃体内注射哌拉西林/他唑巴坦成功治疗 EE,无需玻璃体切除术。: 在因肝病导致凝血功能障碍的患者中,EE 可能表现为酷似 CNVM 的黄斑下出血。临床医生必须认识到这一事实,因为延迟给予适当的抗生素治疗可能导致失明。