Abstract
BackgroundsEndogenous 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 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.ResultsFifteen 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.ConclusionEndogenous 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.
Highlights
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
A study on endogenous endophthalmitis conducted in Korea showed that 25% of primary lesions were liver abscesses [13], whereas a study in Taiwan found that 53% of primary lesions were liver abscesses, and 61% of cases were caused by Klebsiella pneumoniae, and showed the trend of drug resistance [14]
Summary
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. Wang et al BMC Infectious Diseases (2020) 20:661 essential to prevent permanent blindness and mortality. We evaluated the clinical features, surgical strategies, pathogenic bacterial features, and visual outcomes in patients with endophthalmitis caused by liver abscess
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