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Pyogenic liver abscess complicated by endogenous endophthalmitis.

Y M Tan¹, C K Chong, P K Chow

¹Department of Surgery, Singapore General Hospital, 169608, Singapore. gsutym@sgh.gov.sg

ANZ Journal of Surgery

|March 22, 2002

Summary

Pyogenic liver abscess can rarely lead to endogenous endophthalmitis, a severe eye inflammation. Early ophthalmologic consultation is crucial for patients with pyogenic liver abscess to preserve vision.

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Area of Science:

Ophthalmology
Hepatology
Infectious Diseases

Background:

Endogenous endophthalmitis is a severe intraocular inflammation potentially causing vision loss.
Pyogenic liver abscess (PLA) is a rare but serious complication of PLA.

Observation:

A 68-patient cohort treated for PLA over 18 months identified three cases of Klebsiella pneumoniae PLA with concurrent endogenous endophthalmitis.
All affected patients were male and had diabetes mellitus.
Ocular symptoms presented simultaneously with abdominal symptoms in two patients, and three days post-drainage in one patient.

Findings:

No mortality was observed.
Despite aggressive treatment, all patients experienced permanent visual deterioration, with one case resulting in blindness and requiring eye evisceration.

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Klebsiella pneumoniae was identified as the causative pathogen in these cases.

Implications:

Prompt ophthalmologic consultation is essential for patients presenting with ocular symptoms alongside pyogenic liver abscess.
Increased clinical awareness and a high index of suspicion for endophthalmitis are critical for timely diagnosis and management to salvage visual function.