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

Case Reports in Ophthalmological Medicine
Sung Woong LimWon Kyung Song

Abstract

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. 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. 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 w...Continue Reading

References

Jan 1, 1985·Archives of Ophthalmology·W M JayR K Shockley
May 1, 2007·Ophthalmology·Chang-Sue YangWen-Ming Hsu
Jun 30, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Chi-Tai FangShan-Chwen Chang
Nov 17, 2009·Infectious Disease Clinics of North America·Matthew E Levison, Julie H Levison

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