The Korean journal of internal medicine

  • 제30권4호
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  • Pages.453-459
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  • 2015
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  • 1226-3303(pISSN)
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  • 2005-6648(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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Prevalence of and risk factors for endogenous endophthalmitis in patients with pyogenic liver abscesses

  • Park, In Hyung (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jun, Chung Hwan (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Wi, Jin Woo (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Seon Young (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Lee, Wan Sik (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Jung, Sook In (Divisions of Infectious Disease, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Park, Chang Hwan (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Joo, Young Eun (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Kim, Hyun Soo (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Choi, Sung Kyu (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School) ;
  • Rew, Jong Sun (Divisions of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School)
  • 투고 : 2014.05.27
  • 심사 : 2014.10.08
  • 발행 : 2015.07.01
⟨ 이전 논문 다음 논문 ⟩

초록

Background/Aims: 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.

키워드

과제정보

연구 과제 주관 기관 : Chonnam National University Hospital

참고문헌

  1. Yu SC, Ho SS, Lau WY, et al. Treatment of pyogenic liver abscess: prospective randomized comparison of catheter drainage and needle aspiration. Hepatology 2004;39:932-938. https://doi.org/10.1002/hep.20133
  2. Alvarez Perez JA, Gonzalez JJ, Baldonedo RF, et al. Clinical course, treatment, and multivariate analysis of risk factors for pyogenic liver abscess. Am J Surg 2001;181:177-186. https://doi.org/10.1016/S0002-9610(00)00564-X
  3. Fang CT, Lai SY, Yi WC, Hsueh PR, Liu KL, Chang SC. Klebsiella pneumonia genotype K1: an emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin Infect Dis 2007;45:284-293. https://doi.org/10.1086/519262
  4. Wang JH, Liu YC, Lee SS, et al. Primary liver abscess due to Klebsiella pneumoniae in Taiwan. Clin Infect Dis 1998;26:1434-1438. https://doi.org/10.1086/516369
  5. Chung DR, Lee SS, Lee HR, et al. Emerging invasive liver abscess caused by K1 serotype Klebsiella pneumoniae in Korea. J Infect 2007;54:578-583. https://doi.org/10.1016/j.jinf.2006.11.008
  6. Sheu SJ, Kung YH, Wu TT, Chang FP, Horng YH. Risk factors for endogenous endophthalmitis secondary to klebsiella pneumoniae liver abscess: 20-year experience in Southern Taiwan. Retina 2011;31:2026-2031. https://doi.org/10.1097/IAE.0b013e31820d3f9e
  7. Chen YJ, Kuo HK, Wu PC, et al. A 10-year comparison of endogenous endophthalmitis outcomes: an east Asian experience with Klebsiella pneumoniae infection. Retina 2004;24:383-390. https://doi.org/10.1097/00006982-200406000-00008
  8. Yang CS, Tsai HY, Sung CS, Lin KH, Lee FL, Hsu WM. Endogenous Klebsiella endophthalmitis associated with pyogenic liver abscess. Ophthalmology 2007;114:876-880. https://doi.org/10.1016/j.ophtha.2006.12.035
  9. Hu CC, Ho JD, Lou HY, Keller JJ, Lin HC. A one-year follow-up study on the incidence and risk of endophthalmitis after pyogenic liver abscess. Ophthalmology 2012;119:2358-2363. https://doi.org/10.1016/j.ophtha.2012.05.022
  10. Lee S, Um T, Joe SG, et al. Changes in the clinical features and prognostic factors of endogenous endophthalmitis: fifteen years of clinical experience in Korea. Retina 2012;32:977-984. https://doi.org/10.1097/IAE.0b013e318228e312
  11. Sng CC, Jap A, Chan YH, Chee SP. Risk factors for endogenous Klebsiella endophthalmitis in patients with Klebsiella bacteraemia: a case-control study. Br J Ophthalmol 2008;92:673-677. https://doi.org/10.1136/bjo.2007.132522
  12. Smith D, Downey D, Spouge A, Soney S. Sonographic demonstration of Couinaud’s liver segments. J Ultrasound Med 1998;17:375-381. https://doi.org/10.7863/jum.1998.17.6.375
  13. Yang CC, Chen CY, Lin XZ, Chang TT, Shin JS, Lin CY. Pyogenic liver abscess in Taiwan: emphasis on gas-forming liver abscess in diabetics. Am J Gastroenterol 1993;88:1911-1915.
  14. Lau YJ, Hu BS, Wu WL, Lin YH, Chang HY, Shi ZY. Identification of a major cluster of Klebsiella pneumoniae isolates from patients with liver abscess in Taiwan. J Clin Microbiol 2000;38:412-414.
  15. Fung CP, Chang FY, Lee SC, et al. A global emerging disease of Klebsiella pneumoniae liver abscess: is serotype K1 an important factor for complicated endophthalmitis? Gut 2002;50:420-424. https://doi.org/10.1136/gut.50.3.420
  16. Saccente M. Klebsiella pneumoniae liver abscess, endophthalmitis, and meningitis in a man with newly recognized diabetes mellitus. Clin Infect Dis 1999;29:1570-1571. https://doi.org/10.1086/313539
  17. Ohmori S, Shiraki K, Ito K, et al. Septic endophthalmitis and meningitis associated with Klebsiella pneumoniae liver abscess. Hepatol Res 2002;22:307-312. https://doi.org/10.1016/S1386-6346(01)00153-X
  18. Rahimian J, Wilson T, Oram V, Holzman RS. Pyogenic liver abscess: recent trends in etiology and mortality. Clin Infect Dis 2004;39:1654-1659. https://doi.org/10.1086/425616
  19. Lin JC, Chang FY, Fung CP, et al. High prevalence of phagocytic-resistant capsular serotypes of Klebsiella pneumoniae in liver abscess. Microbes Infect 2004;6:1191-1198. https://doi.org/10.1016/j.micinf.2004.06.003
  20. Wiskur BJ, Hunt JJ, Callegan MC. Hypermucoviscosity as a virulence factor in experimental Klebsiella pneumoniae endophthalmitis. Invest Ophthalmol Vis Sci 2008;49:4931-4938. https://doi.org/10.1167/iovs.08-2276
  21. Lin JC, Siu LK, Fung CP, et al. Impaired phagocytosis of capsular serotypes K1 or K2 Klebsiella pneumoniae in type 2 diabetes mellitus patients with poor glycemic control. J Clin Endocrinol Metab 2006;91:3084-3087. https://doi.org/10.1210/jc.2005-2749

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