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Endogenous Klebsiella Pneumoniae Endophthalmitis (EKPE) case series and literature review: A one-year experience at a tertiary referral centre in Malaysia

Nadhir Nuwairi1,2*, Azian Adnan1, Tajunisah Iqbal2

To report 4 cases of Endogenous Klebsiella Pneumoniae Endophthalmitis(EKPE) by highlighting the clinical features, systemic comorbidity, source of infection, treatment modalities and visual outcome.

A retrospective review of electronic medical records of patients with diagnosed with EKPE from January 2017 till December 2017 in Hospital Selayang, which is a main tertiary referral hospital in Malaysia.

A total of 4 patients (5 eyes) were diagnosed with Endogenous Klebsiella Pneumoniae Endophthalmitis(EKPE). The mean age group at presentation was 55.5 years (range 49-61 years) with 3 of whom are male and one female patient. All patients had diabetes mellitus as a systemic risk factor. 3 patients presented with unilateral and one patient presented with bilateral eye involvement. Visual acuity on presentation ranged from 6/60 to perception to light. The primary source of infection were variable, with one each from urinary tract, lung, neck and gluteal infection. The most common positive culture were from blood sample with only one from vitreal fluid. All patients were treated with systemic , topical and intravitreal antibiotics.3 patients underwent vitrectomy following which 1 patients required evisceration. Final visual acuity shows deterioration in all patients of hand movement or worse.

Endogenous Klebsiella Pneumoniae Endophthalmitis (EKPE) is a common human pathogen that can cause rapid and devastating ocular infection with poor visual prognosis. A high index of suspicion among patient with risk factors is needed so that early diagnosis and adequate treatment is given thus improving final outcome.