Risk factors for endogenous endophthalmitis secondary to Klebsiella pneumoniae liver abscess

Background. To identify the risk factors for endogenous endophthalmitis secondary to Klebsiella pneumniae (KP) liver abscess. Methods. Retrospective chart review of 200 patients with KP liver abscess from 1990 to 2000 was performed. Data variables included age, sex, past history, systemic condition, initial and final visual acuity, slit lamp biomicroscopy, intraocular pressure, fundus, course and treatment. Results. Extrahepatic metastasis developed in 44 patients, including 18 cases (23 eyes) of endophthalmitis. Seventeen eyes had final vision less than counting fingers. Diabetes had significant association with the development of extrahepatic metastasis (p = 0.045) and the poor visual outcome of endophthalmitis (p = 0.022), whereas, neither the initial vision nor vitrectomy was significantly related to the outcome of endophthalmitis. Conclusions. The visual prognosis of endogenous endophthalmitis secondary to KP liver abscess is generally poor, and diabetes might be a significant risk factor for the poor visual outcome. Even when the initial vision is as bad as light perception only, some eyes can be saved. Both internists and ophthalmologists should be alert enough to detect and treat these patients early.