Abstract

Purpose: To report a unique case of Klebsiella pneumonia endophthlamitis in which the patient’s ocular cultures were vital in identifying a liver abscess despite negative blood cultures and minimal abdominal symptomology. 

Observations: ­The patient presented with pain and vision loss with a concern for endogenous endophthalmitis. Computerized Tomography (CT) scan of her orbits did not demonstrate significant intraocular or orbital pathology. Blood cultures did not grow any organism. Vitreous cultures grew Klebsiella pneumonia. A CT of her abdomen identified a liver abscess, which was biopsied and grew Klebsiella pneumonia. The patient ultimately required enucleation of the affected eye and was treated with systemic antibiotics and surgical drainage of her liver abscess. 

Conclusions and Importance: This case highlights the previously well-noted association of endogenous Klebsiella endophthalmitis (EKE) with liver abscesses. Most reported cases present with systemic symptoms related to the infectious dissemination of Klebsiella, and or positive blood cultures. Our case is atypical in that our patient was referred to us for an eye issue without any suspected systemic problem identified. A positive vitreous culture and a high degree of suspicion despite a lack of significant abdominal symptomatology led us to pursue abdominal imaging identifying her liver abscess and potentially preventing further life-threatening complications. 

Keywords:Klebsiella Pneumonia; Endophthalmitis; Liver Abscess; Blood Culture

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Citation

Citation: Ghassan Ghorayeb., et al. “Atypical Presentation of Disseminated Klebsiella Pneumonia Endophthalmitis with Pyogenic Liver Abscess”. Acta Scientific Ophthalmology 3.4 (2020): 08-12.

Copyright

Copyright: © 2020 Ghassan Ghorayeb., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.