기저질환 없던 환자에서 발생한 전방의 염증을 동반하지 않은 양안 폐렴막대균 내인성 전안구염

• 영문명: Bilateral Endogenous Klebsiella Pneumoniae Panophthalmitis without Anterior Chamber Reaction in a Previously Healthy Patient
• 발행기관: 대한검안학회
• 저자명: 황성수(Sung Soo Hwang) 이수정(Soo Jung Lee)
• 간행물 정보: 『Annals of optometry and contact lens』Vol.15 No.2, 61~66쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2016.06.30

영문 초록

Purpose: To report a case of bilateral endogenous Klebsiella pneumoniae panophthalmitis causing blindness in both eyes without anterior chamber reaction in a previously healthy patient. Case summary: A 78-year-old woman presented with sudden visual loss in both eyes since 3 days ago. Initial visual acuity was no light perception in both eyes. Intraocular pressure was 52 mmHg/55 mmHg. Anterior chamber depth was very shallow, and 360 degrees posterior synechiae was observed bilaterally. There were no hypopyon and cell in the anterior chamber. The patient had general weakness and abdominal pain since 1 month ago. Liver abscess in the S5 segment and septic emboli in both lungs were noted on the abdominal computed tomography. Brain MRI showed multiple brain abscesses. B-scan sonography showed choroidal thickening and dense haziness in the vitreous cavity. The patient was treated by percutaneous catheter drainage. Bilateral eyelid edema and ocular movement limitation developed on the fifth day after first visit. Paranasal sinus computed tomography showed bilateral panophthalmitis. Klebsiella pneumoniae was cultured in the pus obtained by percutaneous catheter drainage. Bilateral endogenous Klebsiella panophthalmitis was diagnosed. The patient had injection of intravitreal vancomycin and ceftazidime 3 times. However, endophthalmitis was not controlled and finally corneal perforation requiring evisceration occurred in the right eye. The left eye was maintained as phthisis. Conclusions: Klebsiella panophthalmitis can occur even in a previously healthy patient. Thus, when there are sudden visual loss and eyelid edema, even though there is no anterior chamber reaction, panophthalmitis should be suspected.

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키워드

Anterior chamber Endophthalmitis Eye evisceration Klebsiella pneumoniae Panophthalmitis