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Klebsiella pneumoniae infective endocarditis originating from asymptomatic prostatitis presenting with papilloedema

Nuala Pepper1, Markus Reuber2, Rachel Foster3

  • 1Foundation Programme, United Lincolnshire Hospitals NHS Trust, Lincoln, UK nualapepper@gmail.com.

BMJ Case Reports
|June 27, 2025
PubMed

Insights

A young, healthy man developed severe infective endocarditis (IE) caused by Klebsiella pneumoniae originating from asymptomatic prostatitis. This case highlights papilledema as a potential presenting sign of K. pneumoniae IE in immunocompetent individuals.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Ophthalmology

Background:

  • Klebsiella pneumoniae is a growing global health concern due to hypervirulent strains causing severe infections.
  • Infective endocarditis (IE) is a life-threatening condition, often associated with specific risk factors.
  • Young, immunocompetent individuals are typically considered low risk for developing IE.

Purpose of the Study:

  • To report a rare case of subacute infective endocarditis caused by Klebsiella pneumoniae in a young, healthy male.
  • To highlight the unusual presentation of papilledema as a sign of IE.
  • To underscore the potential for Klebsiella pneumoniae to cause severe infections in unexpected patient populations.

Main Methods:

  • Case report of a previously healthy male in his 30s presenting with headache, papilledema, and fever.
  • Blood cultures positive for Klebsiella pneumoniae.
  • Transthoracic echocardiography to diagnose infective endocarditis.
  • Fluorodeoxyglucose positron emission tomography (FDG-PET) to identify the source of infection.

Main Results:

  • The patient was diagnosed with subacute infective endocarditis affecting the aortic and mitral valves.
  • Klebsiella pneumoniae was identified as the causative pathogen.
  • FDG-PET revealed an asymptomatic prostatitis as the likely origin of the infection.
  • Papilledema was a presenting neurological sign.

Conclusions:

  • Young, healthy, immunocompetent patients can develop severe Klebsiella pneumoniae infective endocarditis.
  • Asymptomatic prostatitis can be the source of Klebsiella pneumoniae IE.
  • Papilledema may serve as an early indicator of Klebsiella pneumoniae IE, even in the absence of typical risk factors.
Keywords:
Infectious diseasesProstateValvar diseases

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