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Klebsiella pneumoniae liver abscess and endophthalmitis

Ayeshah Abdul-Hamid1, Sarah-Jane Bailey

  • 1Guy's and St Thomas' Hospital, London, UK. a.abdul-hamid@doctors.org.uk

BMJ Case Reports
|April 6, 2013
PubMed

Insights

This case report details the first UK instance of Klebsiella pneumoniae liver abscess with endophthalmitis. Early recognition and treatment are crucial for managing this emerging infectious disease.

Area of Science:

  • Infectious Diseases
  • Hepatology
  • Ophthalmology

Background:

  • Klebsiella pneumoniae is a common pathogen causing liver abscesses, particularly virulent K1 and K2 serotypes.
  • Liver abscesses due to K pneumoniae are increasingly reported in Europe and North America, moving beyond their prevalence in Southeast Asia.
  • Diabetes mellitus is a primary risk factor for developing K pneumoniae liver abscess.

Observation:

  • A 36-year-old man presented with endophthalmitis, elevated inflammatory markers, and abnormal liver function tests.
  • An abdominal ultrasound revealed a liver abscess necessitating percutaneous drainage.
  • Klebsiella pneumoniae was identified as the causative agent from multiple infection sites.

Findings:

  • The patient was diagnosed with K pneumoniae liver abscess and endophthalmitis, a rare presentation in the UK.
  • The infection involved metastatic spread from the liver to the eye.
  • Successful management involved antibiotics, ophthalmology consultation, and percutaneous drainage.

Implications:

  • This case highlights the growing threat of K pneumoniae liver abscesses in Western countries.
  • Prompt diagnosis and multidisciplinary management, including antibiotics and drainage, are vital for reducing patient morbidity and mortality.
  • Increased awareness among clinicians is necessary for early recognition of this potentially devastating syndrome.

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