Lee Jae Jung, Hong Seung Baek, Lee Nam Kyung, Park Young Joo, Kim So Hee, Park Sung Who, Byon Iksoo, Kim Suk
Department of Ophthalmology, Biomedical Research Institute, Pusan National University Hospital, School of Medicine, Pusan National University, Pusan 46241, Korea.
JRYN Eye Clinic, Pusan 47296, Korea.
J Clin Med. 2022 Jul 28;11(15):4376. doi: 10.3390/jcm11154376.
Endogenous endophthalmitis (EE) associated with Klebsiella pneumoniae (K. pneumoniae)-related pyogenic liver abscess (PLA) is one of the fatal complications of PLA and leads to loss of vision. Early diagnosis and treatment are important to save the patient’s vision. We investigated the characteristics of computed tomography (CT) in EE associated with K. pneumoniae-related PLA for the identification of the predictors of EE, in order to facilitate early diagnosis. A total of 274 patients diagnosed with K. pneumoniae-related PLA, including 15 patients with EE, were identified between January 2005 and December 2019. The clinical (age, gender, and underlying disease) and radiologic (the location, size, and number of abscesses) features were reviewed. In addition, the involvement of the adjacent vessels, such as the hepatic vein and portal vein, was carefully reviewed. A comparative analysis was performed between the EE and non-EE groups. Uni- and multivariate logistic regression analyses were used to identify the predictors of EE. Diabetes mellitus (DM), the involvement of the left or both hepatic lobes, and the adjacent vessels on the CT were significantly more frequent than those in the non-EE group (p < 0.05 in all), and they were the significant predictors of EE in the logistic regression analyses. In patients with K. pneumoniae-related PLA, the CT findings, such as the locations of the abscess (i.e., left or both lobes) and the involvement of the adjacent vessels, should be considered in addition to the ocular symptoms for an early diagnosis of EE.
与肺炎克雷伯菌相关的化脓性肝脓肿（PLA）所致的内源性眼内炎（EE）是PLA的致命并发症之一，可导致视力丧失。早期诊断和治疗对于挽救患者视力至关重要。我们研究了与肺炎克雷伯菌相关的PLA所致EE的计算机断层扫描（CT）特征，以确定EE的预测因素，以便于早期诊断。2005年1月至2019年12月期间，共确定了274例诊断为肺炎克雷伯菌相关PLA的患者，其中包括15例EE患者。回顾了临床特征（年龄、性别和基础疾病）和放射学特征（脓肿的位置、大小和数量）。此外，还仔细检查了肝静脉和门静脉等相邻血管的受累情况。对EE组和非EE组进行了比较分析。采用单因素和多因素逻辑回归分析来确定EE的预测因素。糖尿病（DM）、左肝叶或双侧肝叶受累以及CT上的相邻血管受累在EE组中明显比非EE组更常见（均p < 0.05），并且它们是逻辑回归分析中EE的重要预测因素。对于肺炎克雷伯菌相关PLA患者，除眼部症状外，还应考虑CT表现，如脓肿位置（即左叶或双侧叶）和相邻血管受累情况，以便早期诊断EE。
