A Liver Abscess Deprived a Healthy Adult of Eyesight: Endogenous Endophthalmitis Associated with a Pyogenic Liver Abscess Caused by Serotype K1 &lt;i&gt; Klebsiella Pneumonia&lt;/i&gt;

Maruno, Takahisa; Ooiwa, Yoko; Takahashi, Ken; Kodama, Yuzo; Takakura, Shunji; Ichiyama, Satoshi; Chiba, Tsutomu

doi:10.2169/internalmedicine.52.9076

Cited by 17 publications

(17 citation statements)

References 12 publications

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“…Capsular serotype K1 has been generally considered to be the predominant virulent strain of K. pneumoniae capable of producing a capsular polysaccharide-presenting hypermucoviscosity, which is more resistant to phagocytosis [14,15,16]. A recent report has documented that serotype K1 K. pneumoniae is also capable of causing ocular or CNS complications from pyogenic liver abscess [17].…”

Section: Discussionmentioning

confidence: 99%

“…A recent report has documented that serotype K1 K. pneumoniae is also capable of causing ocular or CNS complications from pyogenic liver abscess [17]. Other factors associated with the invasive syndrome are hypermucoviscous phenotype, presence of virulence-associated genes such as rmpA and magA ; magA is a part of the gene cluster for serotype K1 capsular formation [14,15,16], and rmpA is a regulatory gene responsible for the hypermucoviscous phenotype [1]. Yu et al [18] had reported previously that the presence of the rmpA gene may contribute to expression of the hypermucoviscosity phenotype, in addition, the metastatic infection.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Ventriculitis Associated with Renal Abscess Caused by Serotype K1Klebsiella pneumoniae

et al. 2014

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Recently, serotype K1 Klebsiella pneumoniae has been a major agent of an invasive syndrome characterized by liver abscess and its metastatic infection. Extrahepatic infection and its characteristics in patients with renal abscess caused by K. pneumoniae are poorly understood, and few cases of central nervous system infection have been reported. This is a report of 80-year-old woman with uncontrolled type 2 diabetes mellitus with renal abscess caused by serotype K1 K. pneumoniae, complicated with ventriculitis despite of appropriate use of antibiotics. Physicians need to be aware of possibility of metastatic infection in patients with serotype K1 K. pneumoniae infection, if they develop neurologic symptom and focus of infection is still present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case of Ventriculitis Associated with Renal Abscess Caused by Serotype K1Klebsiella pneumoniae

et al. 2014

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“…pneumoniae'ye bağlı invazif karaciğer apsesi sendromu hakkında çalışmalar daha çok Doğu Asya ülkelerinden, özellikle Tayvan'dan bildirilmiştir (4,(6)(7)(8). Son yıllarda ABD, Avrupa ve Avustralya'dan da olgu bildirimleri yapılmıştır (9)(10)(11)(12)(13)(14).…”

Section: İrdelemeunclassified

“…K. pneumoniae suşlarının, belirli primerler kullanılarak polimeraz zincir reaksiyonu (PZR) ile wzx ve wzy lokuslarında K1 ve K2 serotiplerine özgü alellerin saptanmasıyla serotip tayininin yapıldığı bir çalışmada en sık bu iki serotipin neden olduğu saptanmıştır (5). Ek olarak serotip K1 endoftalmi komplikasyonuyla ilişkili bulunmuştur (5,8). Lin ve arkadaşları (18)'nın Hong Kong, Tayvan ve Singapur hastanelerinde yaptığı çok merkezli bir çalışmada, karaciğer apsesi olan ve sağlıklı taşıyıcılarda saptanan K. pneumoniae suşlarının virülansı incelenmiştir.…”

Section: İrdelemeunclassified

Invasive Liver Abscess Syndrome Caused by Klebsiella pneumoniae and Metastatic Infection Causing Vision Loss: A Case Report

Hamidi¹,

Öncül²,

Cetin³

et al. 2015

Klimik Dergisi

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Pyojenik karaciğer apsesi intraabdominal ve biliyer sistem infeksiyonlarının yaygın olmayan bir komplikasyonudur. İnfeksiyon komşuluk yoluyla direkt olarak ya da apandisit ve divertikülit gibi infeksiyon odaklarından hematojen yayılıma bağlı olarak gelişir (1-3). Pyojenik karaciğer apseleri gastrointestinal kanal yoluyla asandan olarak geliştiğinden genellikle polimikrobiktir (1). Ancak Tayvan ve bazı Doğu Asya ülkelerinden yapılan yayınlar-da, özellikle diyabetik hastalarda, intraabdominal ve biliyer sistemle ilgili predispozan faktörler olmaksızın Klebsiella pneumoniae'nin tek etken olarak saptandığı bir invazif karaciğer apsesi sendromu tanımlanmıştır (4-7). Bu olgularda %13 oranında metastatik infeksiyon olarak göz ve merkezi sinir sistemi tutulumu görülmüştür (7). K. pneumoniae'nin K1 ve K2 serotipinin özellikle diya- AbstractInvasive liver abscess syndrome caused by Klebsiella pneumoniae was first reported from Taiwan and related researches were generally conducted in Eastern Asian countries. However, in recent years similar cases are described all around the world. A minority of patients with primary liver abscess develop metastatic infection at other site of the body, but it is more prevalent when the etiologic agent is K. pneumoniae, especially K1 and K2 serotypes. The most common manifestations of metastatic infection are endophthalmitis, meningitis and brain abscess. A 49-year-old non-diabetic male who presented with primary liver abscess due to K. pneumoniae accompanied by endophthalmitis as a metastatic infection is reported to draw attention to this syndrome with high morbidity. Permanent complete vision loss occurred despite systemic and local antibiotic treatment and percutaneous drainage. Serologic subtyping and virulence analysis of the etiologic agent should be performed when this syndrome is suspected. Klimik Dergisi 2015; 28(3): 129-31.

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“…It is associated with underlying immunosuppressive conditions, including diabetes mellitus, HIV infection, indwelling catheters, cardiac disease, renal insufficiency, malignancy, or immunosuppressive therapy (1)(2)(3)(4)(5). Moreover, EBE is a rare but potential complication of neonatal sepsis (6).…”

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confidence: 99%

Klebsiella pneumoniae Induces an Inflammatory Response in an In Vitro Model of Blood-Retinal Barrier

et al. 2014

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c Klebsiella pneumoniae has become an important pathogen in recent years. Although most cases of K. pneumoniae endogenous endophthalmitis occur via hematogenous spread, it is not yet clear which microbial and host factors are responsible for the ability of K. pneumoniae to cross the blood-retinal barrier (BRB). In the present study, we show that in an in vitro model of BRB based on coculturing primary bovine retinal endothelial cells (BREC) and primary bovine retinal pericytes (BRPC), K. pneumoniae infection determines changes of transendothelial electrical resistance (TEER) and permeability to sodium fluorescein. In the coculture model, bacteria are able to stimulate the enzyme activities of endothelial cytosolic and Ca 2؉ -independent phospholipase A 2 s (cPLA 2 and iPLA 2 ). These results were confirmed by the incremental expression of cPLA 2 , iPLA 2 , cyclo-oxygenase-1 (COX1), and COX2 in BREC, as well as by cPLA 2 phosphorylation. In supernatants of K. pneumoniae-stimulated cocultures, increases in prostaglandin E 2 (PGE 2 ), interleukin-6 (IL-6), IL-8, and vascular endothelial growth factor (VEGF) production were found. Incubation with K. pneumoniae in the presence of arachidonoyl trifluoromethyl ketone (AACOCF 3 ) or bromoenol lactone (BEL) caused decreased PGE 2 and VEGF release. Scanning electron microscopy and transmission electron microscopy images of BREC and BRPC showed adhesion of K. pneumoniae to the cells, but no invasion occurred. K. pneumoniae infection also produced reductions in pericyte numbers; transfection of BREC cocultured with BRPC and of human retinal endothelial cells (HREC) cocultured with human retinal pericytes (HRPC) with small interfering RNAs (siRNAs) targeted to cPLA 2 and iPLA 2 restored the pericyte numbers and the TEER and permeability values. Our results show the proinflammatory effect of K. pneumoniae on BREC, suggest a possible mechanism by which BREC and BRPC react to the K. pneumoniae infection, and may provide physicians and patients with new ways of fighting blinding diseases.

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A Liver Abscess Deprived a Healthy Adult of Eyesight: Endogenous Endophthalmitis Associated with a Pyogenic Liver Abscess Caused by Serotype K1 <i> Klebsiella Pneumonia</i>

Cited by 17 publications

References 12 publications

A Case of Ventriculitis Associated with Renal Abscess Caused by Serotype K1Klebsiella pneumoniae

A Case of Ventriculitis Associated with Renal Abscess Caused by Serotype K1Klebsiella pneumoniae

Invasive Liver Abscess Syndrome Caused by Klebsiella pneumoniae and Metastatic Infection Causing Vision Loss: A Case Report

Klebsiella pneumoniae Induces an Inflammatory Response in an In Vitro Model of Blood-Retinal Barrier

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