Endogenous Endophthalmitis Caused by <b><i>Klebsiella pneumoniae</i></b>: A Ten-Year Retrospective Study in Western China

<b><i>Objectives:</i></b> The aim of this study was to analyse the clinical features, microbiology results, management and outcomes of patients with endogenous endophthalmitis caused by <i>Klebsiella pneumoniae</i> in western China. <b><i>Methods:</i></b> A retrospective review of medical records of 10 eyes in 10 subjects diagnosed with endogenous <i>K. pneumoniae</i> endophthalmitis from January 2008 to December 2018 was undertaken. <b><i>Results:</i></b> The top 3 predisposing medical conditions included diabetes mellitus (50%), malignancy (20%) and cardiac stent implantation (10%). Extraocular infective foci were mainly found in the liver (40%), lungs (20%) and kidneys (10%). The positive culture rate was 85.71% (6/7) in vitreous samples, 83.33% (5/6) in blood samples and 100% (4/4) in body fluid samples. Only 20% of the patients, who had good initial visual acuity (VA) better than hand movement (HM), achieved a final VA better than 1.0 (log MAR). The mortality rate was 10%. <b><i>Conclusions:</i></b> Though the prognosis of endogenous <i>K. pneumoniae</i> endophthalmitis is often poor, patients with an initial VA better than HM may have a good prognosis under comprehensive treatments, including vitrectomy, systemic sensitive antibiotic injection and drainage of the primary infection loci.