More Than Meets the Eye: Klebsiella pneumoniae Invasive Liver Abscess Syndrome Presenting with Endophthalmitis.
J Emerg Med
; 52(6): e221-e223, 2017 Jun.
Article
in En
| MEDLINE
| ID: mdl-28285868
ABSTRACT
BACKGROUND:
Endophthalmitis is a feared complication of pyogenic liver abscesses caused by hypervirulent Klebsiella pneumoniae strains. First described in East Asia in the 1980s, this invasive syndrome is only recently emerging in Europe and America. CASE REPORT We describe an 84-year-old man who presented to the emergency department with fever, orbital cellulitis, and bilateral visual loss. Although the patient had no overt abdominal symptoms, computed tomography scan revealed a pyogenic liver abscess. Blood cultures were positive for K. pneumoniae. Initial treatment consisted of intravenous ceftriaxone and intravitreal ceftazidime. A unilateral vitrectomy was performed. The patient survived with severe visual sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS? K. pneumoniae pyogenic liver abscess with metastatic endophthalmitis is a relatively new syndrome that should be considered in patients presenting with acute vision loss who appear septic, with or without abdominal complaints. Early recognition prohibits delays in lifesaving treatment.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Klebsiella Infections
/
Endophthalmitis
/
Liver Abscess, Pyogenic
Type of study:
Etiology_studies
Limits:
Aged80
/
Humans
/
Male
Language:
En
Journal:
J Emerg Med
Journal subject:
MEDICINA DE EMERGENCIA
Year:
2017
Type:
Article
Affiliation country:
Belgium