Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses

Background/Aims: Although pyogenic liver abscesses (PLAs) can be successfully treated, the visual prognosis of patients with endogenous endophthalmitis (EE) associated with a PLA is poor. Early diagnosis and prompt intervention may salvageuseful vision. Therefore, we investigated risk factors for EE...

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Bibliographic Details
Published inThe Korean journal of internal medicine Vol. 30; no. 4; pp. 453 - 459
Main Authors In Hyung Park, Chung Hwan Jun, Jin Woo Wi, Seon Young Park, Wan Sik Lee, Sook In Jung, Chang Hwan Park, Young Eun Joo, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew
Format Journal Article
LanguageKorean
Published 대한내과학회 31.07.2015
Subjects
Endophthalmitis
Klebsiella pneumonia
Liver abscess
Risk factors
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Summary:Background/Aims: Although pyogenic liver abscesses (PLAs) can be successfully treated, the visual prognosis of patients with endogenous endophthalmitis (EE) associated with a PLA is poor. Early diagnosis and prompt intervention may salvageuseful vision. Therefore, we investigated risk factors for EE in patients with PLA, to facilitate early diagnosis. Methods: Data from 626 patients diagnosed with PLA between January 2004 and July 2013 were analyzed retrospectively. Patients were divided into two groups: those with liver abscess-associated endogenous endophthalmitis (LAEE) and non- LAEE. Results: The prevalence of EE in PLA patients was 1.92%. The mean age for all patients (373 males, 59.6%) was 62.8 years. Upon multivariate logistic regression, a liver abscess or another systemic infection (odds ratio [OR], 5.52; p = 0.005), an abscess in the right superior segment (OR, 5.26; p = 0.035), and Klebsiella pneumoniae infection (OR, 3.68; p = 0.039), were risk factors for LAEE. The final visual outcomesof patients with LAEE included no light perception in seven, hand motion only in three, and decreased visual acuity in two. Vitrectomy and early intravitreal injections of antibiotics improved visual acuity and preserved useful vision. Conclusions: PLA patients with other systemic infections, abscesses in the rightsuperior segment, and K. pneumoniae infection require close monitoring and early intervention to treat LAEE. Intravitreal antibiotic injections or early vitrectomy may salvage useful vision.
Bibliography:The Korean Association Of Internal Medicine
ISSN:1226-3303
2005-6648