內因性細菌性眼內炎－七年的回溯性報告

目的：本篇主要目的在討論近七年來內因性細菌性眼內炎的誘發因子、致病菌種、感染來源、視力預後、以及治療的方式。方法：收集國泰綜合醫院自民國八十五年一月至民國九十一年十二月共十四個病例，以回溯性的方式加以分析。結果：九位是男性，五位是女性；平均年齡為56歲（範圍從30歲到82歲）。百分之九十的病人有先前的內科疾病，包含了糖尿病、肝膿瘍、高血壓、肺部疾病、心臟疾病、癌症、蜂窩性組織炎以及慢性副鼻竇炎等；13個病例可從血液或玻璃體培養出病茵，Klebsiella pneumoniae是最常見的病菌；感染的來源可在14個病人中的13個發現，而肝膿瘍乃是最常見的感染來源（9個病人）。我們發現Klebsiella pneumoniae眼內炎的病人，全部皆有產生視網膜前膿瘍，且有兩個病人尚有視網膜下膿瘍。討論：雖然有各種強效的抗生素可供使用，大部分病人視力預後仍十分不良，因此，視力的改善有賴於警覺性及早期正確的診斷，且須積極地以內科及手術方式治療。

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並列摘要

Purpose: to report the predisposing factors, causative organisms, source of infection., visual outcome and the treatment in cases of endogenous bacterial endophthalmitis. Methods: Fourteen patients with endogenous endophthalmitis were identified by review of admission records of Cathay General Hospital from Jan. 1996 to Nov. 2002. Results: Nine of the patients were male and five were female. The median age was 56 years (range from 30 years old to 82 years old) Ninety percents of the patients had prior medical condition, including diabetes mellitus, liver abscess, hypertension, pulmonary disorders, cardiac disorders, malignancy, cellulitis and chronic parasinusitis. Organism was identified either in blood culture or vitreous culture in 13 of 14 patients. Klebsiella pneumoniae was the most common organism. Sources of infection were identified in 13 of 14 patients, with liver abscess being the most common. Due to easy abscess formation in Klebsiella pneumoniae infection, we found Klebsiella pneumoniae endophthalmitis all with preretinal abscess' and two with subretinal abscess formation. Discussion: The visual prognosis of the endogenous endophthalmitis was dismal. Improved outcome may be associated with early diagnosis and early combined medical and surgical treatment.

並列關鍵字

Endogenous endophthalmitis ； Klebsiella pneumoniae ； Liver abscess

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內因性細菌性眼內炎－七年的回溯性報告

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