Endophthalmitis with Klebsiella pneumoniae liver abscess.
Endogenous endophthalmitis is a rare, but devastating complication of septicemia. The prognosis of maintaining visual acuity in patients with septic endophthalmitis is poor in spite of an early diagnosis and the timely start of conventional therapeutic procedures because the intravitreous drug concentration remains low after the systemic administration of antibiotics due to the blood-ocular barrier. We treated an elderly female patient with endogenous endophthalmitis complicated with disseminated intravascular coagulation associated with a Klebsiella pneumoniae liver abscess. Endophthalmitis developed rapidly and we thus had to perform an enucleation of both eyeballs even though we made an early diagnosis and performed liver abscess drainage as well as the prompt systemic and subconjunctival administration of antibiotics. Our experience in treating this case emphasizes the need to perform the timely intravitreous infusion of antibiotics with a support therapy consisting of the systemic and subconjunctival administration of antibiotics for endogenous endophthalmitis associated with a Klebsiella pneumoniae liver abscess.
Clinical Research Center, National Nagasaki Medical Center, Nagasaki 856-8562, Japan.
Kazufumi
K
Dohmen
Hideo
H
Okubo
Hironao
H
Okabe
Hiromi
H
Ishibashi
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D004322:Drainage; D009877:Endophthalmitis / Q000209:etiology / Q000382:microbiology* / Q000628:therapy; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008100:Liver Abscess / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D011379:Prognosis; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification
D000900:Anti-Bacterial Agents