Risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess.

Shwu-Jiuan Sheu, Li-Chen Chou, May-Ching Hong, Ya-Chuan Hsiao, Yung-Ching Liu
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Abstract

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.

肺炎克雷伯菌肝脓肿继发内源性眼内炎的危险因素。
背景:探讨肺炎克雷伯菌肝脓肿继发内源性眼内炎的危险因素。方法:对1990 ~ 2000年收治的200例KP肝脓肿患者进行回顾性分析。数据变量包括年龄、性别、既往病史、全身状况、初始和最终视力、裂隙灯生物显微检查、眼压、眼底、疗程和治疗。结果:44例患者发生肝外转移,其中眼内炎18例(23眼)。17只眼睛的最终视力低于数手指。糖尿病与肝外转移的发生(p = 0.045)和眼内炎的视力差有显著相关性(p = 0.022),而初始视力和玻璃体切除术与眼内炎的预后均无显著相关性。结论:KP肝脓肿继发内源性眼内炎的视力预后普遍较差,糖尿病可能是其预后不良的重要危险因素。即使最初的视力只有光感那么差,也有一些眼睛是可以得救的。内科医生和眼科医生都应该保持足够的警惕,及早发现和治疗这些患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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