過去5年間の内因性細菌性眼内炎の検討

Five-year review of endogenous endophthalmitis

　過去5年間に内因性細菌性眼内炎7例7眼を当科で治療した。3例に糖尿病の既往があり，原発巣は肝膿瘍3例，足壊疽，歯肉炎，心臓弁膜症各1例などであった。クレブシエラが2例に検出された。3例で失明が回避でき，うち2例に硝子体手術，1例に薬物治療が行われた。発熱から抗生物質の点滴を開始するまでの期間は平均6日で，1週間以内に開始した5例中3例で失明が回避できた。糖尿病などの基礎疾患があり，肝膿瘍などで発熱を伴う眼症状が生じた場合には，内因性細菌性眼内炎を疑い，早急に対処すべきである。

We reviewed 7 eyes of 7 patients with endogenous bacterial endophthalmitis during the past 5-year pe-riod. Diabetes mellitus was present in 3 cases. The primary lesions comprised hepatic abscess 3 cases and one case each of foot gangrene, gingivitis and valvular heart disease. Klebsiella pneumoniae was isolated in 2 cases. Blindness could be avoided in 3 cases, following vitrectomy in 2 cases and medications in 1. The interval between onset and start of treatment with antibiotics averaged 6 days. Blindness was avoided in 3 out of 5 cases in which treatment started within 7 days after onset. The findings show that bacterial endophthalmitis is a liability needing immediate treatment when fever and eye manifestations develop in patients of diabetes mellitus or liver abscess.