Chiu C T, Lin D Y, Liaw Y F
Liver Unit, Chang Gung Memorial Hospital, Chang Gung Medical College, Taipei, Taiwan.
J Clin Gastroenterol. 1988 Oct;10(5):524-7. doi: 10.1097/00004836-198810000-00009.
In a consecutive series of 180 patients with pyogenic liver abscess, three patients (two men and one woman, between 46 and 75 years of age) had metastatic Klebsiella endophthalmitis. The incidence of metastatic endophthalmitis was 1.7% in patients with pyogenic liver abscess, 5.2% in patients with Klebsiella liver abscess, and 7.8% in patients with Klebsiella liver abscess having Klebsiella bacteremia. Despite aggressive therapeutic measures, the men permanently lost their vision and the woman eventually required an evisceration of her right eye. Delayed recognition and/or treatment as well as the nature of bacteria probably contributed to the tragic outcome. The findings suggest that a high index of suspicion is critical and a combined effort of the internist and ophthalmologist is mandatory.
在一系列连续的180例化脓性肝脓肿患者中，有3例（2名男性和1名女性，年龄在46至75岁之间）发生了转移性克雷伯菌眼内炎。化脓性肝脓肿患者中转移性眼内炎的发生率为1.7%，克雷伯菌肝脓肿患者中为5.2%，克雷伯菌肝脓肿合并克雷伯菌菌血症的患者中为7.8%。尽管采取了积极的治疗措施，两名男性永久性失明，女性最终需要摘除右眼。识别和/或治疗延迟以及细菌的特性可能导致了这一悲惨结局。这些发现表明，高度的怀疑指数至关重要，内科医生和眼科医生的共同努力是必不可少的。
