Klebsiella pneumoniae and vision loss
Klebsiella pneumoniae has gained significant attention from clinicians over the years because of its capability to cause life-threatening disease. The strains of the bacteria also have the ability to acquire new genetic material. The two pathotypes causing disease are termed as K. pneumoniae (cKp) and hypervirulent K.pneumoniae (hvKp). Both of these are global pathogens but most cases are because of hvKp which has steadily increased over the past few decades in countries comprising the Asian Pacific Rim. Till date disease caused by cKp has been evident in Western countries, whereas infection because of hvKp is more common outside Asia.
Case study
This article describes the case of a 45-year-old with a history of diabetes mellitus who presented to the ophthalmology clinic with pain and decreased vision in his left eye with a history of 5 days. Examination showed that the patient’s temperature was 39.2°C with a pulse of 144 beats per minute. Further examination of the left eye which showed diffuse conjunctival injection and a dense cataract with no light perception. Doctors suspected the patient of having endogenous endopthalmitis with systemic infection and referred the patient to the emergency department.
A contrast-enhanced computed tomography of the chest, abdomen and pelvis was done which showed the presence of abscesses in the lungs, liver, kidneys and prostate. Doctors administered the patient with intravenous and intravitreal antibiotic agents and advised a percutaneous drainage of the abscesses in the liver and prostate. Blood culture of pus from the abscesses in the liver and prostate grew Klebsiella pneumoniae, and the hypervirulent K1 serotype. Klebsiella pneumoniae is known for causing pyogenic abscesses in different sites, including the soft tissues, urinary tract, lungs, centra nervous system and liver.
Doctors advised the patient to undergo a vitrectomy which he did not during his visit. He showed recovery but had a complete loss of vision in his left eye at 2-month follow-up.
Source: NEJM
