An Unusual Case of Endogenous Klebsiella Pneumonia Endophthalmitis.

Jung, Seung Il; Han, Ji Sang; Yang, Ji Ho; Kim, Do Gyun

doi:2017.58.11.1301

J Korean Ophthalmol Soc > Volume 58(11); 2017 > Article

Case Report

Journal of the Korean Ophthalmological Society 2017;58(11):1301-1306.
DOI: https://doi.org/10.3341/jkos.2017.58.11.1301 Published online November 15, 2017.

An Unusual Case of Endogenous Klebsiella Pneumonia Endophthalmitis.

Seung Il Jung, Ji Sang Han, Ji Ho Yang, Do Gyun Kim

Department of Ophthalmology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea. Kimdk89@empas.com

내인폐렴막대균안내염의 드문 임상경과 1예

정승일⋅한지상⋅양지호⋅김도균

서남대학교 의과대학 명지병원 안과학교실

Correspondence: Do Gyun Kim,
Email: Kimdk89@empas.com

Received: 30 March 2017 • Revised: 28 August 2017 • Accepted: 19 October 2017

Abstract

PURPOSE
To report an unusual case of endogenous endophthalmitis in a patient with Klebsiella pneumoniae primary liver abscess. CASE SUMMARY: A-54-year-old man with diabetes mellitus and liver abscess was referred to us for consultation of visual loss in his left eye for 2 days. On the first examination, the patient's left visual acuity was hand motion and the left intraocular pressure was 13 mmHg. Vitreous opacity and inflammatory membrane were detected with increased echogenicity using ultrasonography. Vitectomy and intravitreous antibiotic injection were performed under the impression of endogenous endophthalmitis caused by liver abscess on the day of the first visit. Culture revealed Klebsiella pneumoniae from blood and liver abscess. After vitrectomy, the patient showed improvement. However, on the 20th and 40th postoperative days, the patient complained of blurred vision, and inflammation and hypopyon were observed in the anterior chamber. An intracameral antibiotic injection and anterior chamber washing were performed. The patient has not complained of any other symptoms to date. CONCLUSIONS: In this patient with endophthalmitis, inflammation and hypopyon in the anterior chamber were evident three times after vitrectomy. Ultimately, the inflammation was effectively controlled by intracameral antibiotic injection and anterior chamber washes.

Key Words: Endogenous endophthalmitis;Hypopyon;Klebsiella pneumoniae;Liver abscess