Presentation and outcome of a cluster of patients with endogenous endophthalmitis: a case series

The aim of this study was to investigate the clinical features and visual acuity outcomes associated with endogenous endophthalmitis.

Seven eyes of 6 patients treated at Epsom and St Helier University Hospitals between 2010 and 2013 were reviewed for endogenous endophthalmitis.

Patients were followed for a mean of 7 months (range 1 to 13). Positive blood cultures were obtained in 5 patients (83%), including 1 patient with fungal isolates (17%), two patients with Gram-positive isolates and another two with Gram-negative isolates. Five patients (83%) were hospitalized at the time of diagnosis and 2 patients (33%) died within 6 months of diagnosis. Initial treatment included vitreous tap and injection of intravitreal antibiotics. Only in one eye (14%) were positive results from the biopsy obtained. Four eyes (57%) achieved a final visual acuity of >6/60. Patients with a Klebsiella endophthalmitis had worse visual outcome.

Endogenous endophthalmitis is generally associated with high mortality and poor visual acuity outcomes. Gram-negative species are associated with poorer visual acuity. Vitreous biopsy has a weak diagnostic relevance as is it often negative.