肺炎克雷伯杆菌性肺炎致内源性眼内炎一例

Endogenous Endophthalmitis Caused by Klebsiella Pneumoniae Pneumonia: A Case Report

摘要: 49岁男性，因“头痛3 d，左眼眼红眼痛2 d”入院(Vod0.8, Vos0.3, NCTod13.8 mmHg, os9.9 mmHg)。裂隙灯检查见左眼混合充血(++)，角膜水肿(+)，角膜后可见尘状沉着物(+++)，前房积脓，液平高1 mm，瞳孔圆，d = 3 mm，对光反射迟钝，晶状体皮质不均匀灰白色混浊，眼底窥不清。右眼无特殊。初步诊断为急性虹膜睫状体炎。鉴别诊断为眼内炎。患者入院后，予以局部抗炎、局部及全身抗感染、玻璃体切除术治疗。术后随访视力恢复可。讨论：患者有疑似眼内炎的非特征性症状出现时，应考虑是否有内源性眼内炎的可能，一旦确诊立即对眼内炎症病灶做出相应治疗措施，挽救患者的视力，降低后遗症的发生率。

Abstract: A 49-year-old man was admitted with headache for 3 days and red and pain for 2 days in the left eye. Visual acuity was 0.8 in the right eye and 0.3 in the left. The left eye was revealed under slit lamp to be with mixed hyperemia (++), corneal edema (+), KP (+++), anterior chamber empyema, fluid level 1mm, pupil circle, d = 3 mm, and the light reflection is slow, the lens cortex is uneven and grayish and cloudy, and the fundus is unclear. The right eye is nothing special. NCT: od13.8 mmHg, os9.9 mmHg. The initial diagnosis was acute iridocyclitis. The differential diagnosis is endophthalmitis. After the patient was admitted to the hospital, he was treated with local anti-inflammatory, local and systemic anti-infection, and vitrectomy. The visual acuity can be recovered after the follow-up. Discussion: When the patient has non-characteristic symptoms suspected of endophthalmitis, it should be considered whether there is the possibility of endogenous endophthalmitis. Once the diagnosis is made, corresponding treatment measures should be taken to the inflammatory lesions in the eye to save the patient’s vision and reduce the sequelae the rate of occurrence.