A Case of Endophthalmitis and Abscesses in the Liver and the Lung Caused byKlebsiella Pneumoniae

Abstract

[Case report] A 65-year-old male war admitted to a local hospital because of fever. He was treated with piperacillin and clindamycin without noticeable effect. He began to complain of loss of vision on the third hospital day and culture of the blood specimen yielded Klebsiella pneumoniae. He was diagnosed as endophthalmitis and referred to our hospital for further examination. The hematological laboratory test showed leukocytosis (12,700/microliter) and increased CRP (20.4 mg/dl). A computed tomographic (CT) scan of the thorax revealed multiple lung abscesses. An abdominal ultrasonographic scan and a CT scan of the abdomen revealed multiple liver abscesses. We drained the abscess in the liver and Klebsiella pneumoniae was detected from the sample of aspirated fluid and his sputum. Meropenem was administered intravenously. Fever started to improve on the tenth hospital day and the size of both liver and lung abscesses were reduced. He has lost vision of his right eye. He was discharged after sixty days. He did not have any immunosuppressive underlying disease including HIV infection and diabetes mellitus which cause these lesions.

A Novel Virulence Gene in Klebsiella pneumoniae Strains Causing Primary Liver Abscess and Septic Metastatic Complications

“…Nevertheless, mortality rates as high as 10% for primary liver abscess (4-9) and 30-40% among those with metastatic meningitis have been reported (11,12). In addition to being particularly common in Taiwan (4), where Ͼ 900 cases have been reported (4-10), this invasive K. pneumoniae disease has also been reported in North America (13,14), Europe (15)(16)(17)(18)(19), and Japan (20,21).…”

Cryptogenic invasive Klebsiella pneumoniae liver abscess syndrome

“…In the USA, 41% of all K. pneumoniae infections are now community-acquired; 4,5 the incidence is even higher in Taiwan, where it has been reported to be as high as 68%. 6,7 In contrast to the 55% mortality associated International Journal of Infectious Diseases (2007) 11, [16][17][18][19][20][21][22] http://intl.elsevierhealth.com/journals/ijid KEYWORDS Pyogenic liver abscess; Bacterial meningitis; Klebsiella pneumoniae; Thrombocytopenia; Lung abscess; Bacteremia; Diabetes mellitus; Taiwan Summary Background: Klebsiella pneumoniae-associated liver abscesses have distinct clinical and epidemiologic features. Methods: We report the unusual case of an American patient with a K. pneumoniae-associated liver abscess and septic spread to other organs.…”

Absceso hepático asociado a absceso pulmonar y endoftalmitis

“…Al momento solo existe un reporte que incluya absceso hepático, absceso pulmonar y endoftalmitis por Klebsiella, en el que tampoco se demostró algún tipo de inmunosupresión. 27 La mortalidad por absceso hepático oscila entre un 6 -19,6%, especialmente cuando hay alteraciones de la funciones de varios órganos, incluyendo falla renal. 28,29 Por tal razón, es primordial un diagnóstico oportuno y el tratamiento apropiado.…”