国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (6): 455-461.doi: 10. 3760/cma.j.cn115500-20250725-25607

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内源性眼内炎诊断和治疗的研究进展

张燈1  谷峰2  张锡帆3  张晓玉 张欣3   

  1. 1 厦门市杏林医院感染科,厦门 361000; 2 中国医科大学附属第一医院眼科,沈阳 110001; 3 中国医科大学附属第一医院感染性疾病一科,沈阳 110001

  • 收稿日期:2025-07-25 出版日期:2025-12-22 发布日期:2025-12-22
  • 通讯作者: 张欣,Email:zhangxin800705@163.com
  • 基金资助:
    社区感染性疾病科研能力建设项目(BCF-XC-SQ-20221206-01)

Research advances in the diagnosis and treatment of endogenous endophthalmitis

Zhang Deng1, Gu Feng2, Zhang Xifan3, Zhang Xiaoyu3, Zhang Xin3   

  1. 1 Department of Infectious Diseases, Xiamen Xinglin Hospital, Xiamen 361000, China; 2 Department of Ophthalmology, The First Affiliated Hospital of China Medical University, Shenyang 110001, China; 3 First Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, Shenyang 110001, China
  • Received:2025-07-25 Online:2025-12-22 Published:2025-12-22
  • Contact: Zhang Xin, Email: zhangxin800705@163.com
  • Supported by:
    Community Infectious Diseases Research Capacity Building Project (BCF-XC-SQ-20221206-01)

摘要: 内源性眼内炎是一种严重的致盲性感染性疾病。在东亚地区高毒力肺炎克雷伯菌是最主要的病原体,感染者多伴有肝、肺、泌尿系统等全身多部位侵袭性感染。本病好发于合并糖尿病、免疫抑制状态或肾脏疾病等基础疾病的患者,可累及任何年龄段人群。其诊断主要依据临床表现及眼科专科检查,不完全依赖于微生物学培养结果。治疗上,目前仍以全身抗感染治疗联合局部治疗为主,近年来也出现了多种新型抗菌策略,具有良好的应用前景。

关键词: 内源性眼内炎, 高毒力肺炎克雷伯菌

Abstract: Endogenous endophthalmitis is a severe, sight-threatening infectious ocular condition. In East Asia, hypervirulent Klebsiella pneumoniae represents the predominant pathogen, and infected individuals often present with concurrent invasive infections in systemic sites such as the liver, lungs, and urinary tract. The disease predominantly affects patients with underlying conditions such as diabetes, immunosuppression, or renal impairment, and may occur across all age groups. Diagnosis is primarily based on clinical presentation and ophthalmological examination, rather than relying exclusively on microbiological culture results. Current management mainly consists of systemic antimicrobial therapy combined with local treatments. In recent years, several novel antibacterial strategies have emerged, demonstrating considerable potential for future clinical application.

Key words: Endogenous endophthalmitis, Highly virulent Klebsiella pneumoniae