Abstract
Objective: In this article, we review the clinical data of a
case involving chemotherapy-induced bone marrow suppression complicated
by pyogenic liver abscess, leading to endogenous endophthalmitis (EE).
By consulting the relevant literature, we comprehensively analyse and
summarise the information, ultimately offering diagnostic and
therapeutic insights for similar cases.
Methods: This article presents the case of a 65-year-old female
patient with breast cancer who developed bone marrow suppression during
postoperative chemotherapy. Imaging examinations revealed the presence
of a pyogenic liver abscess, and
the patient subsequently experienced visual impairment. Following a
thorough examination, the diagnosis indicated secondary EE resulting
from a pyogenic liver abscess caused by Klebsiella pneumoniae. Upon
hospitalisation, the patient underwent treatment with granulocyte
colony-stimulating factor (G-CSF) to stimulate bone marrow
haematopoiesis and she also received comprehensive systemic
anti-infective therapy. Additionally, a pyogenic liver abscess drainage
procedure was performed, coupled with intravitreal injection of
antibiotics into the vitreous cavity of the affected eye.
Results: After comprehensive systemic and local treatments, the
patient’s laboratory parameters normalised. The volume of the pyogenic
liver abscess reduced noticeably, allowing for the removal of the
drainage tube. At the time of discharge, there was a reduction in
intraocular inflammation. Nevertheless, complete loss of vision
persisted in the affected eye.
Conclusion: In patients with bone marrow suppression following
chemotherapy, it is crucial to conduct liver imaging examinations to
promptly exclude the possibility of bacterial pyogenic liver abscess. To
prevent serious complications such as EE leading to blindness, timely
pyogenic liver abscess drainage procedures must be performed.
Administering antibiotics empirically for comprehensive systemic
anti-infective therapy, along with localised ocular treatment, is also
essential. This approach preserves vision as much as possible and
enhances the overall prognosis for patients.
Keywords: Bone marrow suppression; Bacterial pyogenic liver
abscess; Endogenous endophthalmitis; Case report