Invasive Klebsiella pneumoniae syndrome

Yaguchi, Daizo; Kimura, H; Shizu, Masato; Ichikawa, Motoshi

doi:10.1093/qjmed/hcz092

Cited by 7 publications

(5 citation statements)

References 6 publications

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“…KPIS is a systemic manifestation caused by hypervirulent Klebsiella pneumoniae resulting in serious lifethreatening community-acquired infections such as liver abscess, pneumonia, meningitis, and endophthalmitis [8][9]. In addition to the liver, it has the ability to metastatically spread (11%-80% of cases) to distant sites like lungs, eyes, kidneys, spleen, and bone marrow [8][9][10]. Diabetics are strongly predisposed to Klebsiella liver abscess and are at higher risk of metastatic spread of infection [6][7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Case Series on Endogenous Klebsiella pneumoniae Endophthalmitis: More Than Meets the Eye

Danapal¹,

Mustapha²,

Malek³

et al. 2021

Cureus

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Endogenous endophthalmitis (EE) is a rare but potentially sight-threatening disease with an appreciable mortality rate. Diabetes mellitus remains the most frequently associated condition especially in the Asian population, which potentiates Klebsiella pneumoniae involvement. Endogenous Klebsiella pneumoniae endophthalmitis (EKE) usually has a poor final visual outcome despite treatment with intravitreal and systemic antibiotics. We report three cases of EKE with systemic involvement Klebsiella pneumoniae invasive syndrome (KPIS). KPIS was diagnosed in three patients with multiple comorbidities who presented with a blurring of vision and eye redness. Patient 1 was a 63-year-old Malay man diagnosed with left eye panophthalmitis with multifocal liver and prostate abscesses. He underwent drainage of the liver abscess and eventually evisceration of the left eye due to scleral perforation. Patient 2 was a 66-year-old Malay woman diagnosed with left eye endophthalmitis. Due to hemodynamic instability, vitrectomy was delayed and eventually sustained corneal perforation and eviscerated. The patient eventually succumbed to infection. Patient 3 was a 42-year-old Malay woman diagnosed with KPIS, renal abscess, lung abscess, and left endogenous endophthalmitis. She underwent a vitrectomy but her postoperative vision remained poor. All patients received multiple intravitreal antibiotics and systemic antibiotics.KPIS is frequently associated with catastrophic disabilities. Our cases highlight the importance of an early suspicion of systemic involvement in patients presenting with EKE. Prompt diagnosis, emergent radiographic evaluation, early adequate drainage, and appropriate treatment with antibiotics potentially improve survival and visual prognosis.

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Section: Discussionmentioning

confidence: 99%

Case Series on Endogenous Klebsiella pneumoniae Endophthalmitis: More Than Meets the Eye

Danapal¹,

Mustapha²,

Malek³

et al. 2021

Cureus

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“…[ 1 ] Since the 1980s, invasive syndrome resulting from the high viscosity of Kp has been frequently reported in East Asia, particularly in Taiwan. [ 2 ] As reported, Kp infection is the cause of community-acquired meningitis in Taiwan, and liver abscesses have a high mortality rate, up to 30–40%. [ 3 ] For ILAS complicated by endophthalmitis, early intervention is warranted to effectively improve the prognosis.…”

Section: Introductionmentioning

confidence: 99%

Blindness in Right Eyes after Enema: A Case of Klebsiella pneumoniae-Related Invasive Liver Abscess Syndrome with Endophthalmitis-Caused Blindness as the First Symptom

Jin,

Zhang,

Yang

et al. 2024

Case Reports in Medicine

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We report a case of Klebsiella pneumoniae invasive liver abscess syndrome (KPILAS) with endophthalmitis-caused blindness as the first symptom after enema. The patient had diabetes, and his blood glucose was poorly controlled. She developed hematuria after four enemas for cosmetic purposes and later became blind. The eye discharge was cultured, which revealed a Klebsiella pneumoniae infection. B ultrasound did not show liver lesions, but computed tomography exhibited abscesses in the right lobe of the liver. Magnetic resonance imaging of the head indicated abscesses. These confirmed the diagnosis of invasive liver abscess syndrome. The patient was given ophthalmic and systemic anti-infection treatments, and her condition was effectively controlled. Unfortunately, the diseased eye still needed to be removed. This case underlines the necessity of avoiding unnecessary risky procedures (such as enemas) in vulnerable populations, the importance of early detection of invasive liver abscess syndrome, and the advantage of computed tomography in detecting liver abscesses.

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“…Extrahepatic complications resulting from bacteremia, including endophthalmitis, meningitis, necrotizing fasciitis, and other illnesses, have also been recorded [4,5]. Increased incidence of a distinct communityacquired invasive K. pneumoniae syndrome has been reported from Taiwan and other Southeast Asian countries [6,7,8]. However, this situation is still rare.…”

Section: Introductionmentioning

confidence: 99%

Klebsiella pneumoniae invasive syndrome with liver abscess and purulent meningitis presenting as acute hemiplegia: a case report

Chen

et al. 2023

Preprint

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Background Klebsiella pneumoniae can infect a variety of sites, with the risk of infection being higher in the immunocompromised state such as diabetes mellitus. A distinct invasive syndrome has been detected mostly in Southeast Asia in the past two decades. A common destructive complication is pyogenic liver abscess that can be complicated by metastatic endophthalmitis as well as the involvement of the central nervous system, causing purulent meningitis or brain abscess. Case presentation We report a rare case of an invasive liver abscess caused by K. pneumoniae, with metastatic infections of meninges. A 68-year-old man with a past medical history of type 2 diabetes mellitus presented to our emergency department as sepsis. Sudden disturbed consciousness was noticed with presentation of acute hemiplegia and gaze preference mimicking a cerebrovascular accident. Conclusions The above case adds to the scarce literature on K. pneumoniae invasive syndrome with liver abscess and purulent meningitis. K. pneumoniae is a rare cause of meningitis and should raise suspicions about the disease in febrile individuals. In particular, Asian patients with diabetes presenting with sepsis and hemiplegia prompt a more thorough evaluation with aggressive treatment.

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Invasive Klebsiella pneumoniae syndrome

Cited by 7 publications

References 6 publications

Case Series on Endogenous Klebsiella pneumoniae Endophthalmitis: More Than Meets the Eye

Case Series on Endogenous Klebsiella pneumoniae Endophthalmitis: More Than Meets the Eye

Blindness in Right Eyes after Enema: A Case of Klebsiella pneumoniae-Related Invasive Liver Abscess Syndrome with Endophthalmitis-Caused Blindness as the First Symptom

Klebsiella pneumoniae invasive syndrome with liver abscess and purulent meningitis presenting as acute hemiplegia: a case report

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