The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses

  • Park, In Hyung (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jun, Chung Hwan (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Wi, Jin Woo (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Seon Young (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lee, Wan Sik (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jung, Sook In (Divisions of Infectious Disease, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Chang Hwan (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Joo, Young Eun (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Hyun Soo (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Choi, Sung Kyu (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Rew, Jong Sun (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School)
  • Received : 2014.05.27
  • Accepted : 2014.10.08
  • Published : 2015.07.01
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Abstract

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 salvage useful 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 outcomes of 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 right superior segment, and K. pneumoniae infection require close monitoring and early intervention to treat LAEE. Intravitreal antibiotic injections or early vitrectomy may salvage useful vision.

Keywords

Acknowledgement

Supported by : Chonnam National University Hospital

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