Bob Ching-Li Cheng, MD (Singapore, Singapore), Soon-Phaik Chee, FRCOphth (Singapore, Singapore), Kah Guan Au Eong, MBBS, FRCS (Singapore, Singapore)

PURPOSE:

To analyse the risk factors, clinical presentation and prognosis of Klebsiella Endogenous Endophthalmitis (KEE) in Singapore.

METHODS:

Retrospective, non-comparative case series looking at culture proven (KEE) cases seen in the Singapore National Eye Centre from 1986-2003.

RESULTS:

A total of 40 patients with 46 eyes, male to female ratio 28:12, mean age 54.3 (25-81) were included. Hepatobiliary tract infection (65%)represented the most common source of infection, followed by Urinary tract (12.5%), chest (7.5%),and others (15%). Hypopyon with posterior diffuse intraocular inflammation was the commonest presentation (72%). Majority (85%) presented with counting fingers or worst visual acuity. Diabetes mellitus was a significant risk factor present in 45% of the patients. 95.6% had positive blood cultures as compared to 56% of positive vitreous cultures. The use of intravitreal antibiotics and vitrectomy did not significantly affect visual outcome. 63% of patients had a final visual acuity of no perception of light.

CONCLUSION:

KEE is a devastating ocular complication of systemic infection with hepatobiliary tract sepsis as the most common source. Diabetic mellitus is an important risk factor (45%). Majority had no perception of light despite intravitreal antibiotics and vitrectomy.