Clinical characteristics of endogenous Klebsiella pneumoniae endophthalmitis: a 13-year experience

Lee, Ji Hwan; Kim, Hee Suk; Byeon, Suk Ho; Kim, Sung Soo; Koh, Hyoung Jun; Lee, Sung Chul; Lee, Christopher Seungkyu

doi:10.1007/s10792-022-02301-w

Cited by 2 publications

(5 citation statements)

References 35 publications

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“…In contrast, Western countries report Gram‐positive bacteria and fungi as the most common pathogens. This type of endophthalmitis has a higher incidence among East Asian populations, particularly in patients with poorly controlled diabetes, with PLA being the most common source of infection 24,32–35 …”

Section: Discussionmentioning

confidence: 99%

“…However, there is still no consensus on the indications and timing of vitrectomy, and the protective effect of vitrectomy on vision and the eyeball remains controversial 1,43,45 . In addition, the administration of dexamethasone via intravitreal injection has not been shown to have a significant correlation with preservation or good visual acuity in the eye 34 …”

Section: Discussionmentioning

confidence: 99%

“…This type of endophthalmitis has a higher incidence among East Asian populations, particularly in patients with poorly controlled diabetes, with PLA being the most common source of infection. 24,[32][33][34][35] PLA caused by K. pneumoniae can occur through four pathways 36 : (1) the biliary tract pathway, which is usually associated with cholelithiasis, malignant tumors, or posthepaticojejunostomy stricture 37 ; (2) the portal vein pathway, which mainly originates from abdominal infections such as appendicitis, diverticulitis, colorectal cancer, and inflammatory bowel disease 38 ; (3) the hepatic artery pathway, which is usually caused by bacteremia from Staphylococcus aureus 38 ; and (4) direct infection from adjacent infected foci. Although some studies have suggested that K. pneumoniae-induced PLA is seldom associated with liver and biliary diseases, previous liver surgery, abdominal trauma, or biliary or portal vein infections caused by malignant tumors, 39,40 mouse model experiments have demonstrated that different mutant strains of K. pneumoniae have varying invasive abilities through different genes.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“… 1 , 43 , 45 In addition, the administration of dexamethasone via intravitreal injection has not been shown to have a significant correlation with preservation or good visual acuity in the eye. 34 …”

Section: Discussionmentioning

confidence: 99%

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Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Chen

Gong

Song

et al. 2023

Immunity Inflam & Disease

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Objective Pyogenic liver abscess (PLA) is a common surgical infectious disease caused by various pathogens. Klebsiella pneumoniae is a relatively recent cause, often affecting patients with low immunity. Endogenous endophthalmitis (EE), a rare and serious complication of PLA, may appear with eye symptoms before PLA. By reviewing a case of Klebsiella pneumoniae‐induced PLA complicated with EE, we want to summarize the information about the characteristics, causes, and complications of PLA based on the literature review. Methods This case report describes a 37‐year‐old male who had fever high to 39°C for 10 days experienced blurred vision followed by nonlight perception vision. He reported a history of diabetes irregularly taking oral medications and insulin therapy. Imaging examination found a large low‐density area in the right lobe of the liver with an unclear border and vague surrounding fat gap. The blood culture was not positive. The culture of the drainage fluid from the liver puncture showed Klebsiella pneumonia. Blood and liver puncture drainage fluid were sent for microbial high‐throughput gene detection with next‐generation sequencing technology (NGS), which confirmed the diagnosis of Klebsiella pneumoniae‐induced PLA complicated with EE. Results The patient's surgical incision had healed well at discharge, and he could feel light at his left eye. But the patient was lost to follow‐up since the third month after discharge. Conclusion By reviewing this case and summarize the information about the characteristics, causes, and complications of PLA based on the literature review, we concluded that it is necessary to promptly perform liver puncture drainage and empirically use antibiotics for patients with PLA, especially those with poor glycemic control, to avoid serious complications such as EE.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Chen

Gong

Song

et al. 2023

Immunity Inflam & Disease

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Two-Decade Retrospective Analysis of Endogenous Endophthalmitis in Spain and Mexico: A Comprehensive Study

de Esteban Maciñeira,

Bande,

Soberanes-Pérez

et al. 2024

JCM

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Objectives: The aim of this study was to investigate endogenous endophthalmitis (EE) in Spain and Mexico, focusing on microbial patterns, antibiotic resistance, infection sources, risk factors, and patient outcomes. Methods: Over 20 years, 705 endophthalmitis cases were reviewed, and we identified 78 cases of EE in Santiago de Compostela, Spain, and Mexico City, Mexico. Microbial etiology, infection sources, antibiotic resistance, and treatment outcomes were compared between patients from Spain and Mexico. Results: Among the 78 EE cases, 47 (60.25%) were from Spain and primarily had bacterial infections (57.1%, mainly Staphylococcus and Streptococcus). In contrast, 31 cases (39.74%) were from Mexico and had a higher prevalence of fungal infections, particularly Candida (47.1%). Diabetes mellitus was a significant risk factor, and was more common in Mexico (61.3%) than in Spain (37.0%). The Spanish cohort exhibited notable antibiotic resistance, especially in Staphylococcus. Treatment typically involved systemic and intraocular antibiotics, with vitrectomy performed in 61.5% cases. Post-treatment, bacterial infections had higher success rates (approximately 50%) compared with fungal infections (approximately 30%). Evisceration was necessary in 9% cases, and the overall mortality rate was approximately 4.4%; it was slightly higher in Mexico than in Spain. Conclusions: The study highlights significant regional differences in EE between Spain and Mexico, particularly regarding microbial etiology and antibiotic resistance. The findings emphasize the need to adapt healthcare practices to specific regions to improve EE treatment outcomes, underscoring the importance of ongoing research and interregional collaboration to better understand and manage this complex condition.

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Clinical characteristics of endogenous Klebsiella pneumoniae endophthalmitis: a 13-year experience

Cited by 2 publications

References 35 publications

Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Pyogenic liver abscess complicated with endogenous endophthalmitis caused by Klebsiella pneumoniae: A case report and Literature Review

Two-Decade Retrospective Analysis of Endogenous Endophthalmitis in Spain and Mexico: A Comprehensive Study

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