Shandong University of Traditional Chinese Medicine, Jinan, China.
Eye Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, China.
Medicine (Baltimore). 2023 Nov 17;102(46):e36139. doi: 10.1097/MD.0000000000036139.
Endogenous endophthalmitis is a vision-threatening intraocular infection caused by hematogenous spread of infectious organisms from distant sites.
A 71-year-old man with a history of fever and dysuria 5 days prior to presentation presented with sudden loss of vision in his left eye. The patient had no history of ocular surgery or trauma, and ocular examination revealed a large amount of exudative plaque covering the pupil. Therefore, fundus examination was not feasible. B-scan ultrasonography revealed a dome-shaped subretinal mass with an exudative retinal detachment.
Endogenous endophthalmitis was diagnosed on the basis of these findings.
The patient underwent pars plana vitrectomy and the early postoperative course was favorable.
Vitreous cultures grew gram-negative bacilli, identified as Klebsiella pneumonia. Urinalysis revealed white blood cells (++) and urinary tract infection was the only identifiable risk factor for endogenous endophthalmitis.
Urinary tract infection is an independent risk factor for endogenous endophthalmitis.
内源性眼内炎是一种由血源性播散引起的、威胁视力的眼内感染，其病原体来自远处的感染部位。
一名 71 岁男性，有发热和尿痛病史，在就诊前 5 天出现左眼视力突然丧失。患者无眼部手术或外伤史，眼部检查发现大量渗出性斑块覆盖瞳孔。因此，无法进行眼底检查。B 型超声显示一个呈穹顶状的视网膜下肿块，伴有渗出性视网膜脱离。
根据这些发现诊断为内源性眼内炎。
患者接受了玻璃体切除术，术后早期恢复良好。
玻璃体培养出革兰氏阴性杆菌，鉴定为肺炎克雷伯菌。尿分析显示白细胞(++)，尿路感染是内源性眼内炎唯一可识别的危险因素。
尿路感染是内源性眼内炎的一个独立危险因素。
