Infectious Sources, Prognostic Factors, and Visual Outcomes of Endogenous Klebsiella pneumoniae Endophthalmitis

Ya Han Li, Yi Hua Chen, Kuan Jen Chen*, Nan Kai Wang, Ming Hui Sun, An Ning Chao, Laura Liu, Yu Jr Lin, Wei Chi Wu, Yih Shiou Hwang, Chi Chun Lai, Tun Lu Chen

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

18 引文 斯高帕斯(Scopus)

摘要

Purpose: To investigate the infectious sources and prognostic factors for poor visual outcome, including subjective symptoms, presenting clinical features, laboratory data, and treatments, in patients diagnosed with endogenous Klebsiella pneumoniae endophthalmitis (EKE) at a tertiary referral center in Northern Taiwan. Design: Retrospective, single-institution, consecutive case series. Participants: One hundred ten consecutive patients (124 eyes) diagnosed with EKE. Methods: One hundred ten patients (124 eyes) were reviewed retrospectively between January 1996 and April 2013. Main Outcome Measures: Visual acuity (VA), subjective symptoms, presenting clinical features, laboratory data, treatments, and requirement of evisceration or enucleation. Results: Of the 110 patients with EKE, 74 (67.3%) were men. Diabetes was the most commonly associated systemic disease (75/110 [68.2%]), and liver abscess was the major infection source (85/110 [77.3%]). In addition, 91 of 124 eyes (73.4%) had final VA worse than counting fingers (CF; poor visual outcome), and 20 eyes required evisceration or enucleation. The binary multivariate logistic regression (forward-Wald) model revealed that poor initial VA worse than CF (odds ratio [OR], 8.8; 95% confidence interval [CI], 2.2–36; P = 0.002), positive vitreous culture results (OR, 9.8; 95% CI, 1.7–56.1; P = 0.010), posterior focal EKE (OR, 0.15; 95% CI, 0.03–0.8; P = 0.027), and the presence of intravitreal dexamethasone administration (OR, 0.19; 95% CI, 0.04–0.9; P = 0.030) were the significant independent factors for visual outcomes. Conclusions: Liver abscess was the major infection source, and EKE typically has poor visual prognosis. Early diagnosis and prompt treatment may salvage useful vision in some eyes. Early diagnosis with fair initial VA and intravitreal antibiotic and dexamethasone combination therapy may have beneficial effects on visual outcomes.

原文英語
頁(從 - 到)771-778
頁數8
期刊Ophthalmology Retina
2
發行號8
DOIs
出版狀態已出版 - 08 2018

文獻附註

Publisher Copyright:
© 2017 American Academy of Ophthalmology

指紋

深入研究「Infectious Sources, Prognostic Factors, and Visual Outcomes of Endogenous Klebsiella pneumoniae Endophthalmitis」主題。共同形成了獨特的指紋。

引用此