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Pyogenic liver abscess complicated by endogenous endophthalmitis
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.
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.
- 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.