Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess
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RESEARCH ARTICLE
Open Access
Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess Yue Wang, Xue Wang and Yu Di*
Abstract Backgrounds: Endogenous endophthalmitis is a serious disease caused by intraocular infection that can rapidly progress to cause blindness. This study evaluated the clinical features, surgical and antibiotics treatment strategies, and treatment outcomes in patients with endophthalmitis caused by liver abscess. Methods: Between April 2014 and April 2019, the clinical data of 16 patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we evaluated the final visual outcomes in the patients to determine the efficacy of surgery. Results: Fifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) only underwent intravitreal injection. Of the 16 patients, 3 patients (3 eyes) had recurrent intraocular inflammation and eventually underwent evisceration. Systemic antibiotics were administered for all patients based on the results of vitreous humor culture, blood culture, and antibiotic susceptibility tests. Outpatient follow-ups were performed until the patients were stable (6 months). Of the 19 eyes, 1 eye (5%) had visual acuity restored to 20/200, 6 eyes (31%) had visual acuity restored to counting fingers (CF), 2 eyes (11%) had visual acuity restored to hand motion (HM), 4 eyes (22%) showed only light perception (LP), and the remaining 6 eyes (31%) showed no light perception (NLP). Drug susceptibility tests suggested that the carbapenems exhibited significant effects in the inflammatory reaction. Conclusion: Endogenous endophthalmitis caused by liver abscess is a very serious condition, and the final visual outcome is poor. Timely surgical intervention combined with antibiotic treatment is essential, and the primary disease must be treated to control disease progression at the earliest. Keywords: Endogenous endophthalmitis, Klebsiella pneumoniae, Liver abscess, Vitrectomy, Visual acuity
Background Endophthalmitis is an ocular disease that can lead to serious visual acuity damage [1, 2]. Endogenous endophthalmitis as a result of liver abscess is caused by the hematogenous spread of pathogenic bacteria from the liver abscess, which passes through the blood–retinal * Correspondence: [email protected] Department of Ophthalmology, Shengjing Hospital of China Medical University, Heping district, Sanhao Road 36, Shenyang 110004, People’s Republic of China
barrier, leading to infection of the eye [3]. In recent years, many cases have been reported in Asia, with Klebsiella pneumoniae being the most common causative agent [4, 5]. Since the disease is relatively occult during the early stage, it can rapidly infect intraocular tissues, resulting in irreversible damage to the photoreceptor cells in the retina. This causes irreversible damage to the eye, leading to a significant impact on visual functi
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