Risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess.
BACKGROUND
To identify the risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae (KP) liver abscess.


METHODS
Retrospective chart review of 200 patients with KP liver abscess from 1990 to 2000 was performed. Data variables included age, sex, past history, systemic condition, initial and final visual acuity, slit lamp biomicroscopy, intraocular pressure, fundus, course and treatment.


RESULTS
Extrahepatic metastasis developed in 44 patients, including 18 cases (23 eyes) of endophthalmitis. Seventeen eyes had final vision less than counting fingers. Diabetes had significant association with the development of extrahepatic metastasis (p = 0.045) and the poor visual outcome of endophthalmitis (p = 0.022), whereas, neither the initial vision nor vitrectomy was significantly related to the outcome of endophthalmitis.


CONCLUSIONS
The visual prognosis of endogenous endophthalmitis secondary to KP liver abscess is generally poor, and diabetes might be a significant risk factor for the poor visual outcome. Even when the initial vision is as bad as light perception only, some eyes can be saved. Both internists and ophthalmologists should be alert enough to detect and treat these patients early.
Sheu
Shwu-Jiuan
SJ
National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC. sjsheu@isca.vghks.gov.tw
Chou
Li-Chen
LC
Hong
May-Ching
MC
Hsiao
Ya-Chuan
YC
Liu
Yung-Ching
YC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D009877:Endophthalmitis / Q000209:etiology*; D015818:Eye Infections, Bacterial / Q000209:etiology*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications*; D007711:Klebsiella pneumoniae; D008100:Liver Abscess / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors