Two Cases of Bilateral Endogenous Klebsiella pneumoniae Endophthalmitis in Primary Klebsiella pneumoniae Liver Abscess Patients

Jung Mo Han; Nam Ju Kim

doi:10.3341/jkos.2009.50.10.1590

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Han and Kim: Two Cases of Bilateral Endogenous Klebsiella pneumoniae Endophthalmitis in Primary Klebsiella pneumoniae Liver Abscess Patients

Original Article

J Korean Ophthalmol Soc 2009;50(10):1590-1594.

Published online: 3 August 2009

DOI: https://doi.org/10.3341/jkos.2009.50.10.1590

Two Cases of Bilateral Endogenous Klebsiella pneumoniae Endophthalmitis in Primary Klebsiella pneumoniae Liver Abscess Patients

Jung Mo Han, MD¹, Nam Ju Kim, MD^1,²

¹Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea

²Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea

Address reprint requests to Nam Ju Kim, MD Department of Ophthalmology, Seoul National University Bundang Hospital #300 Gumi-dong, Bundang-gu, Seongnam 463-707, Korea Tel: 82-31-787-7376, Fax: 82-31-787-4057, E-mail: resourceful@hanmail.net

Received 18 August 2008 Accepted 7 July 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report 2 cases of bilateral endogenous endophthalmitis in patients with Klebsiella pneumoniae primary liver abscess.

Case summary

A 78-year-old woman and a 76-year-old woman presented with bilateral blurred vision for 2 to 3 days. The women had fever, cough, and chills for 5 to 10 days. Abdominal computed tomography revealed liver abscess and ophthalmologic examination results suggested bilateral endophthalmitis. In both patients, Klebsiella pneumoniae was identified from the liver abscess aspirate. In one patient, Klebsiella pneumoniae was also identified from a vitreous sample. Both patients lost their vision despite intravitreal and intravenous antibiotics injection.

Keywords: Bilateral endogenous endophthalmitis, Klebsiella pneumoniae, Primary liver abscess

References

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Figure 1.

Photographs of patient 1. (A) Photograph of the right eye on the day of admission. Note severe corneal edema and hypopyon. (B) Ultrasonography revealed vitreous opacity and choroidal thickening. (C) On abdominal computed tomography (CT), multiseptated cystic mass (about 6.7×3.9×3.8 cm in size) with adjacent parenchymal enhancement was found in the right lobe of the liver, which confirmed the diagnosis of liver abscess. (D) Photograph of the left eye on the 4^th day of admission. Note the corneal perforation and uveal prolapse.

Figure 2.

Abdominal CT finding of patient 2. Low attenuated, 6 cm-sized mass was found at the left lobe of the liver, consistent with liver abscess.

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