title: Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: In Hyung
authors.initials: IH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Chung Hwan
authors.initials: CH
authors.lastname: Jun
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Wi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Wan Sik
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Division of Infectious Disease, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sook In
authors.initials: SI
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Joo
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D042241:Early Diagnosis; D009877:Endophthalmitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D000900:Anti-Bacterial Agents
keywords: Endophthalmitis; Klebsiella pneumonia; Liver abscess; Risk factors