PURPOSE: To identify the risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess. METHODS: We conducted a retrospective review of medical records of 602 patients admitted with K. pneumoniae liver abscess from January 1991 to November 2009. Variables included age, sex, history, month of onset, systemic condition, initial and final visual acuities, slit-lamp biomicroscopy, intraocular pressure, fundus, course and treatment. RESULTS: Endophthalmitis was identified in 42 patients (53 eyes). Nineteen eyes (35.8%) had final vision of counting fingers or better. Diabetes was significantly associated with the development of endophthalmitis (P = 0.003) and poor visual outcome (P = 0.019). Poor initial vision (worse than counting fingers) was also significantly related to the poor visual outcome of endophthalmitis (P < 0.001). Subgroup analysis of 9 vitrectomy cases showed that progressive anterior chamber reaction might be related to poor visual outcome. Moreover, patients whose disease onset was in winter were slightly more likely to develop endophthalmitis (P = 0.088). CONCLUSION: Although the prognosis of endogenous K. pneumoniae endophthalmitis is generally poor, some eyes might be saved if treated early enough. Diabetes is a significant risk factor for the development of endogenous endophthalmitis and poor visual outcome in patients with K. pneumoniae liver abscess. Early vitrectomy might be considered in patients whose anterior chamber inflammation did not respond well to intravitreal antibiotics.
PURPOSE: To identify the risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess. METHODS: We conducted a retrospective review of medical records of 602 patients admitted with K. pneumoniae liver abscess from January 1991 to November 2009. Variables included age, sex, history, month of onset, systemic condition, initial and final visual acuities, slit-lamp biomicroscopy, intraocular pressure, fundus, course and treatment. RESULTS:Endophthalmitis was identified in 42 patients (53 eyes). Nineteen eyes (35.8%) had final vision of counting fingers or better. Diabetes was significantly associated with the development of endophthalmitis (P = 0.003) and poor visual outcome (P = 0.019). Poor initial vision (worse than counting fingers) was also significantly related to the poor visual outcome of endophthalmitis (P < 0.001). Subgroup analysis of 9 vitrectomy cases showed that progressive anterior chamber reaction might be related to poor visual outcome. Moreover, patients whose disease onset was in winter were slightly more likely to develop endophthalmitis (P = 0.088). CONCLUSION: Although the prognosis of endogenous K. pneumoniae endophthalmitis is generally poor, some eyes might be saved if treated early enough. Diabetes is a significant risk factor for the development of endogenous endophthalmitis and poor visual outcome in patients with K. pneumoniae liver abscess. Early vitrectomy might be considered in patients whose anterior chamber inflammation did not respond well to intravitreal antibiotics.
Authors: Chun Yue Mak; Mary Ho; Lawrence Pui-Leung Iu; Helena Pui-Yee Sin; Li Jia Chen; Grace Lui; Marten Erik Brelen; Alvin Lerrmann Young Journal: Int J Ophthalmol Date: 2020-12-18 Impact factor: 1.779
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 Journal: Korean J Intern Med Date: 2015-06-29 Impact factor: 2.884
Authors: Zenith H Y Wu; Rose P S Chan; Fiona O J Luk; David T L Liu; Carmen K M Chan; Dennis S C Lam; Timothy Y Y Lai Journal: J Ophthalmol Date: 2012-02-23 Impact factor: 1.909