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


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


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


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.


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.