Infect Chemother.  2011 Dec;43(6):485-489. 10.3947/ic.2011.43.6.485.

A Case of Renal Abscess associated with endogeneous endophthalmitis and septic pulmonary embolism by Klebsiella pneumoniae

• Jung J
• Jang Y
• Choi G
• Min KW
• Han K
• Park J

• KMID: 2170360
• DOI: http://doi.org/10.3947/ic.2011.43.6.485

Abstract

Klebsiella pneumoniae is a pathogen that causes a wide range of infections in the human body and has a tendency to metastasize to multiple organs. Endogenous Klebsiella endophthalmitis is an infrequent but often devastating septic metastatic infection. It tends to be fulminant and often rapidly progresses to permanent visual loss beyond 24 hours after symptom onset, despite therapy with appropriate antibiotics, particularly with a delay in diagnosis and treatment. While endogenous Klebsiella endophthalmitis has mostly been reported in association with primary liver abscesses, it has rarely been reported with other Klebsiella infections including renal abscesses. Here, we present a case of a 73-year-old diabetic female diagnosed with a Klebsiella renal abscess and endogenous endophthalmitis, after developing left flank pain and bilateral decreased visual acuity. She was treated with systemic antibiotics, percutaneous abscess drainage, an intravitreal antibiotics injection, and a vitrectomy. While the renal abscess slowly resolved, the symptoms of endophthalmitis persisted despite treatment. This report suggests that endogenous endophthalmitis should be considered when diabetic patients with renal abscesses complain of ocular symptoms.

Keyword

Abscess; Klebsiella pneumoniae; Endophthalmitis

MeSH Terms

Abscess
Aged
Anti-Bacterial Agents
Drainage
Endophthalmitis
Female
Flank Pain
Human Body
Humans
Klebsiella
Klebsiella Infections
Klebsiella pneumoniae
Liver Abscess
Pulmonary Embolism
Visual Acuity
Vitrectomy
Anti-Bacterial Agents

Figure

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  Figure 1 A B-scan orbital ultrasonogram shows a dense vitreous solution with high opacity and multiple abnormal vitreous spikes in the both eyes.

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  Figure 2 (A) Initial abdominal CT scan reveals Lt. APN with an air-containing abscess (7.5 cm) with perinephric infiltration and fluid (arrow). (B) Initial chest CT scan reveals multiple nodules in both lungs, suggestive of a septic embolism (arrow). (C, D) Follow-up CT scan after 4 weeks reveals interval resolution of inflammatory lesion.

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