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Endogenous endophthalmitis associated with pyogenic hepatic abscess
1Department of Surgery, Chang Gung Memorial Hospital at Kaohsiung, Taiwan, Republic of China.
Journal of the American College of Surgeons
|January 1, 1996
Summary
Endogenous endophthalmitis can occur in patients with pyogenic hepatic abscess, often caused by Klebsiella pneumoniae. Early diagnosis and prompt intravitreous treatment are crucial for preserving vision.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Hepatology
Background:
- Endogenous endophthalmitis is increasingly linked to pyogenic hepatic abscesses.
- Klebsiella pneumoniae is a frequent causative agent in these cases.
Purpose of the Study:
- To determine the incidence of endophthalmitis in pyogenic hepatic abscess patients.
- To identify the association with Klebsiella pneumoniae.
- To evaluate treatment outcomes.
Main Methods:
- Retrospective study of 352 pyogenic hepatic abscess patients (1986-1993).
- Inclusion of ophthalmologic evaluations and treatment results.
- Causative organism identification via blood, hepatic aspirate, and vitreous cultures.
Main Results:
- 3.1% incidence of endogenous endophthalmitis (11/352 patients).
- Klebsiella pneumoniae was the predominant pathogen.
- Despite treatment, 10 out of 14 affected eyes resulted in blindness, with delays in treatment impacting outcomes.
Conclusions:
- Physicians must suspect endogenous endophthalmitis in pyogenic hepatic abscess patients with ocular symptoms.
- Prompt diagnosis and intravitreous vancomycin, amikacin, and dexamethasone within 24 hours are vital for vision preservation.