Liu Y C, Cheng D L, Lin C L
Arch Intern Med. 1986 Oct;146(10):1913-6.
Metastatic septic bacterial endophthalmitis is a rare, but devastating disease. We encountered seven cases of pyogenic liver abscess associated with septic endophthalmitis during a recent four-year period. The causative organism was a pure culture of Klebsiella pneumoniae. The diagnosis was made by results of a blood culture in seven of the cases, liver aspirate culture in four, and eye contents or conjunctival culture in four. Chest roentgenographic examination showed pulmonary embolization in four patients, purulent meningitis in one patient, and suspicious prostatic abscess in one patient. Despite diligent antibiotic therapy, six patients lost their vision and one had impaired vision. This poor outcome for septic endophthalmitis seems to result from delayed diagnosis and lack of scheduled periocular injections of antibiotics. A combination course of treatment by the internist and ophthalmologist acting aggressively, both diagnostically and therapeutically, is needed in the future. To have seven cases of K pneumoniae liver abscess complicated by septic endophthalmitis during a period of four years in one hospital is very unusual. To our knowledge, it has never been reported in the literature.
转移性化脓性细菌性眼内炎是一种罕见但极具破坏性的疾病。在最近四年期间，我们遇到了7例与化脓性眼内炎相关的化脓性肝脓肿病例。致病菌为肺炎克雷伯菌纯培养物。7例通过血培养结果确诊，4例通过肝穿刺培养确诊，4例通过眼内容物或结膜培养确诊。胸部X线检查显示4例患者有肺栓塞，1例患者有化脓性脑膜炎，1例患者有可疑前列腺脓肿。尽管进行了积极的抗生素治疗，6例患者失明，1例视力受损。化脓性眼内炎的这种不良结局似乎是由于诊断延迟和缺乏定期的眼周抗生素注射所致。未来需要内科医生和眼科医生在诊断和治疗方面积极合作的联合治疗方案。在一家医院的四年时间里出现7例肺炎克雷伯菌肝脓肿并发化脓性眼内炎的情况非常罕见。据我们所知，文献中从未有过报道。
