scholarly journals Analysis of Clinical Characteristics of 19 Patients with Endophthalmitis Caused by Liver Abscess

2021 ◽  
Author(s):  
guangsen liu ◽  
Yue Li ◽  
Wei Wang ◽  
Lei Gao
Keyword(s):  
Visual Acuity ◽  
Liver Abscess ◽  
Diagnosis And Treatment ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Microbial Culture ◽  
Poor Vision ◽  
Ocular Symptoms ◽  
History Of ◽  
First Time

Abstract Objective: To analyze the clinical features, treatment, and prognosis of endophthalmitis caused by a liver abscess.Methods: All cases of endogenous endophthalmitis caused by a liver abscess in our hospital in the past 7 years were analyzed retrospectively. The data collected included age, sex, history of diabetes, initial and final vision, pathogen, course of the disease, treatment, and prognosis.Results: 21 eyes of 19 patients were complicated with liver abscess. The average age was 55.9 ±9.8 years old, including 10 males (52.6%) and 9 females (44.4%), 13 patients complicated with diabetes (71.4%), 14 patients (66.7%) first went to the ophthalmology department for diagnosis and treatment and 5 with hepatobiliary surgery (33.3%). 14 patients had a fever before onset, with an average fever time of 5.8 days. Before treatment, the duration of ocular symptoms was 7.71 ±6.68 days, 5.71 ±1.25 days for patients who go to ophthalmology for diagnosis and treatment for the first time, and 12.2 ±3.58 days for patients who go to other departments. After treatment, the average visual acuity of 21 eyes was 0.013, and the average best-corrected visual acuity was 0.79. In the 21 eyes, vitreous fluid culture was positive in 7 eyes (33.3%), all of which were Klebsiella pneumonia. Among the 14 patients with fever during hospitalization, 5 cases were positive for blood microbial culture, all of which were Klebsiella pneumonia. After vitrectomy, the average visual acuity was improved by 4.90 ±2.47 letters and that of patients without vitrectomy was-0.25±0.16letters. The visual acuity of patients who underwent postoperative visual was significantly better than that of patients without postoperative visual (P＜0.096). The visual acuity of patients without vitrectomy was significantly higher than that of patients without vitrectomy (P ＜0.01). 3 eyes (33.3%) of 9 eyes in the IVI group were removed because of uncontrolled inflammation, and 1 eye of 12 eyes in the PPV group was removed because of inflammation recurrence.Conclusion: The prognosis of endogenous endophthalmitis caused by liver abscess is generally poor, but early treatment can save part of the vision. The first visit non-ophthalmology department will delay the early diagnosis of the disease. Diabetes is an important risk factor for endogenous endophthalmitis and poor vision in patients with liver abscess. Klebsiella pneumonia is the main pathogen of intraocular infection. Vitrectomy combined with vitreous injection of antibiotics can improve the prognosis. A systematic and thorough treatment of a liver abscess is of great significance to prevent the recurrence of endophthalmitis in a liver abscess.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

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 surgeryResults: 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.

scholarly journals Endogenous Endophthalmitis Associated with Liver Abscess Successfully Treated with Vitrectomy and Intravitreal Empirical Antibiotics Injections

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sung Woong Lim ◽  
Youngje Sung ◽  
Hee Jung Kwon ◽  
Won Kyung Song
Keyword(s):  
Visual Acuity ◽  
Effective Treatment ◽  
Liver Abscess ◽  
Animal Studies ◽  
Fundus Photography ◽  
Endogenous Endophthalmitis ◽  
Effective Treatment Option ◽  
Vitreous Opacity ◽  
Empirical Antibiotics

Purpose. Klebsiella pneumoniae is the most common pathogen of endogenous endophthalmitis accompanying liver abscess in East Asia. The treatment may be different for the patients with endogenous endophthalmitis from the postoperative endophthalmitis. Prompt administration of both intraocular (vancomycin and ceftazidime) and systemic (ceftriaxone, aminoglycoside, and/or metronidazole) antibiotics have been a mainstay of treatment. However, ceftriaxone has been proven to more effectively kill K. pneumoniae than ceftazidime in in vitro studies, and the safety of intravitreal ceftriaxone has been confirmed in animal studies. Methods. Two diabetic female patients with liver abscess presented with decreased visual acuity of the unilateral eyes. Fundus photography, ocular ultrasonography, and abdominal computed tomography were performed. Results. A 50-year-old diabetic female patient with liver abscess presented decreased visual acuity of the left eye. In fundus examinations, a yellowish necrotic lesion was noted throughout the eye. The results of culture of the blood culture was positive for K. pneumoniae. She was successfully treated with intravitreal ceftazidime injections, and the remaining vitreous opacity was treated with vitrectomy. A 62-year-old female with liver abscess presented a visual symptom of floaters in the right eye. The fundus had a hazy appearance through the vitreous opacity. A yellowish-white subretinal abscess was noted at the temporal macula. Cultures of blood were negative. She underwent intravitreal injections of empirical antibiotics. However, she did not respond to intravitreal vancomycin and ceftazidime. Thus, we changed the intravitreal antibiotics from ceftazidime to ceftriaxone and performed vitrectomy. Her ocular status significantly improved after this change. Conclusion. Our results indicate that for cases with EE, prompt initial treatment with broad spectrum antibiotics, followed by rapid use of antibiotics selected according to culture results, and empirical use of antibiotics in cases of a negative culture may be an effective treatment. Vitrectomy also can be an effective treatment option for vitreous opacity refractory to the treatment.

scholarly journals Persistently poor vision in dim illumination after implantation of XtraFocus small-aperture IOL (Morcher)

2019 ◽  
Vol 12 (11) ◽  
pp. e232473 ◽  
Author(s):  
Prateek Agarwal ◽  
Samuel Edward Navon ◽  
Praveen Subudhi ◽  
Neha Mithal
Keyword(s):  
Visual Acuity ◽  
Cataract Extraction ◽  
Hand Movements ◽  
Blurred Vision ◽  
Small Aperture ◽  
Poor Vision ◽  
Uncorrected Visual Acuity ◽  
The Face ◽  
History Of ◽  
Near Visual Acuity

A 21-year-old patient presents to us with complaints of blurred vision and photophobia in the left eye, with an uncorrected visual acuity of 20/100 improving to 20/30 with pinhole and diagnostic rigid gas permeable lens trial. He had a history of trauma with subsequent cataract extraction, with residual irregular astigmatism and traumatic mydriasis. XtraFocus Pinhole intraocular lens (Morcher) was implanted in the left eye. One week postoperatively, the left eye uncorrected visual acuity improved to 20/30, uncorrected intermediate visual acuity improved to 20/40, and uncorrected near visual acuity improved to J4. The glare and photophobia resolved completely. Surprisingly, the patient complained of severely poor vision in dim illumination. His vision was limited to bare perception of objects and hand movements close to the face. He started facing difficulties in major activities such as driving at night and in dark ambient surroundings such as movie theatres, which persisted to the extent of necessitating explantation of the implant.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Control Disease ◽  
Serious Disease ◽  
Susceptibility Tests

Abstract BackgroundEndogenous 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.MethodsBetween April 2014 and April 2019, the clinical data of patients (19 eyes) with endophthalmitis associated with liver abscess who underwent surgery at Shengjing Hospital were retrospectively analyzed. Furthermore, we also evaluated the degree of visual acuity correction in patients after surgery to determine the efficacy of vitrectomy.ResultsFifteen patients (18 eyes) underwent intravitreal injection followed by vitrectomy after admission. One patient (1 eye) was only underwent intravitreal injection. Three 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 (5.26%) had visual acuity restored to 20/200, 6 eyes (31.58%) had visual acuity restored to counting fingers (CF), 2 eyes (10.53%) had visual acuity restored to hand motion (HM), 4 eyes (21.58%) showed only light perception (LP), and the remaining 6 eyes showed no light perception (NLP),3 patients showed carbapenems resistance.ConclusionEndogenous endophthalmitis caused by liver abscess is occult, and prognosis 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.

Endogenous Endophthalmitis Associated with Pyogenic Liver Abscess Caused by Klebsiella Pneumoniae: A Case Report

2021 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Wael Ferjaoui ◽  
Mohamed Hajri ◽  
Souhail Karwiya ◽  
Seifeddine Baccouche ◽  
Sahir Omrani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Exceptional Case ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Percutaneous Transhepatic Drainage ◽  
Transhepatic Drainage

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

scholarly journals 269. A Review of Gram Negative Endogenous Endophthalmitis at University Hospital in Newark

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S241-S241
Author(s):  
Hernando Salazar ◽  
Catherine Ye ◽  
Brian Schott ◽  
Kristin R Riddle ◽  
Diana Finkel
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Hepatobiliary Disease ◽  
University Hospital ◽  
Endogenous Endophthalmitis ◽  
Gram Negative ◽  
Ocular Symptoms ◽  
Sources Of Infection ◽  
Tract Infections ◽  
Anatomical Success

Abstract Background Endophthalmitis (EO) is an ocular emergency characterized by intraocular inflammation, usually in response to infection. While most cases are exogenous, gram negative (GN) EO account for 10-24% of all cases, and endogenous EO (EEO) account for 2-8% of all cases. Risk factors for EEO include diabetes mellitus (DM), IV drug use, and indwelling catheters. Major sources of infection are urinary tract infections (UTI), liver abscesses, pneumonia, and bacteremia. Common pathogens include K. pneumoniae, P. aeruginosa, and H. influenzae. Outcomes are poor, with only 20% of patients achieving improved visual acuity, and 30-40% requiring enucleation. Methods Retrospective analysis was performed on patients diagnosed with EO (n=89) at University Hospital in Newark from January 2016 to December 2020 using ICD-10 codes H44.0-H44.009, H44.1, and H44.19. Patients included were 18 years of age or older with culture proven GN endogenous EO (GNEEO) (n=7). Outcomes included anatomical success, functional success, and mortality at 28 days and 3 months. Results 7 of 89 patients met criteria for GNEEO (median age 67, 4 males, 71.4% Hispanic/Latino). Comorbidities included hepatobiliary disease (57.1%) and DM (42.9%). All 7 patients presented with ocular symptoms and 3 had non-ocular symptoms. Primary sources of infection included UTI, prostate abscess, and pneumonia/empyema. Eye cultures identified Pseudomonas in 4 patients and Klebsiella in 3 patients. Mean antibiotic length was 17.7 days with 6 patients receiving intravitreal antibiotics. Enucleation was performed in 3 patients. 2 patients had functional success and 4 had anatomical success, with 0 mortality at 28 days and 3 months. Table 1. Ocular symptoms on presentation of cases of gram negative endogenous endophthalmitis Table 2. Positives cultures obtained from cases of gram negative endogenous endophthalmitis Conclusion Although rare, GNEEO causes significant morbidity, with only 2 recovering visual acuity and 3 requiring enucleation. Risk factors, sources of infection, and microbes were all consistent with those in previous reports. Hepatobiliary disease and DM were the most prominent risk factors while sources of infection included UTI and empyema. Eye cultures were positive for K. pneumoniae and P. aeruginosa, two common pathogens previously identified. This case series highlights the importance of prompt recognition and initial treatment of GNEEO with empiric coverage that includes vancomycin and ceftazidime. Disclosures All Authors: No reported disclosures

Endogenous endophthalmitis associated with pyogenic liver abscess caused by Klebsiella pneumoniae: A case report

2021 ◽  
Vol 1 (1) ◽  
pp. 007-009
Author(s):  
Mohamed Hajri ◽  
Souhail Karwiya ◽  
Wael Ferjaoui ◽  
Seifeddine Baccouche ◽  
Sahir Omrani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Klebsiella Pneumoniae ◽  
Liver Abscess ◽  
Hepatic Abscess ◽  
Pyogenic Liver Abscess ◽  
Exceptional Case ◽  
Endogenous Endophthalmitis ◽  
Klebsiella Pneumonia ◽  
Percutaneous Transhepatic Drainage ◽  
Transhepatic Drainage

It is about an exceptional case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumonia. The patient was a 50-year-old female, who was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography showed an abscess measured 8 cm and located in segment 7 of the liver. It was treated by antibiotics and percutaneous transhepatic drainage. Pus sample was positive for Klebsiella pneumoniae. On day 3 after admission, patient complained of a red left eye with decreased vision. The diagnosis of endogenous endophthalmitis was strongly suspected. An Early treatment was initiated with a good evolution. The syndrome Endophthalmitis-hepatic abscess" is an exceptional syndrome rarely reported in the literature. It must evoked in case of hepatic abscess caused by klebsiella pneumonia.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by live abscess

2020 ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

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.

scholarly journals Surgery combined with antibiotics for the treatment of endogenous endophthalmitis caused by liver abscess

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yue Wang ◽  
Xue Wang ◽  
Yu Di
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Liver Abscess ◽  
Treatment Strategies ◽  
Visual Outcome ◽  
Drug Susceptibility ◽  
Endogenous Endophthalmitis ◽  
Light Perception ◽  
Hand Motion ◽  
Susceptibility Tests

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.

Sign in / Sign up

Export Citation Format

Share Document