A 10-year comparison of endogenous endophthalmitis outcomes:: An east Asian experience with Klebsiella pneumoniae infection

Purpose: To evaluate the infection sources and causative organisms in cases of endogenous endophthalmitis and review the outcomes for patients with Klebsiella pneumoniae infection during a 10-year period. Methods: All cases of endogenous endophthalmitis treated at one Taiwanese hospital from July 1992 to June 2002 were retrospectively reviewed (n = 74; 86 eyes). The study was divided into two 5-year periods, with patients stratified into Group F or Group L according to onset date within the first or last of these periods, respectively. The outcomes of cases of K pneumoniae infection in Group L (21 eyes) and Group F (32 eyes) were compared. Results: The major source of infection (liver abscess) and the causative organism (K. pneumoniae) did not change throughout the 1 0-year review period; however, outcomes for Group L appeared superior. The interval from onset of ocular symptoms to ophthalmic consultation was shorter for Group L; however, a statistically significant difference was not demonstrated by between-group comparison. Patients with good final vision typically had good initial vision in cases of K. pneumoniae infection. Conclusion: The authors' experience with endogenous endophthalmitis has confirmed the findings of analogous East Asian studies, with liver abscess as the major source of infection and K. pneumoniae as the causative organism. Superior outcome may be achieved with more comprehensive and collaborative management, ideally through the combined efforts of multiple medical subspecialties.