Klebsiella Endophthalmitis as Retinal Vasculitis with Prostatic Abscess

Optom Vis Sci. 2015 Jul;92(7):e158-60. doi: 10.1097/OPX.0000000000000617.

Abstract

Purpose: To describe an unusual case of endogenous Klebsiella endophthalmitis associated with prostatic abscess in an immunocompetent patient.

Case report: A 59-year-old previously healthy man presented with rapidly progressive retinal vasculitis in the left eye. He received an empirical antibiotic and antiviral agent intravenously followed by oral prednisolone until the etiology was identified; however, intraocular inflammation in the left eye continued to worsen, followed by the development of subretinal abscess in the contralateral eye. Finally, a diagnosis of endogenous Klebsiella endophthalmitis associated with prostatic abscess was made through a culture of the vitreous acquired by diagnostic vitrectomy. However, we could not save the vision of the left eye despite the intensive treatment with intravenous and intravitreal injections of antibiotics.

Conclusions: Rapidly progressive retinal vasculitis could be an initial sign of endogenous Klebsiella endophthalmitis even in an immunocompetent patient.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / drug therapy
  • Abscess / microbiology*
  • Anti-Bacterial Agents / therapeutic use
  • Ceftazidime / therapeutic use
  • Drug Therapy, Combination
  • Endophthalmitis / diagnosis
  • Endophthalmitis / drug therapy
  • Endophthalmitis / microbiology*
  • Eye Infections, Bacterial / diagnosis
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology*
  • Glucocorticoids / therapeutic use
  • Humans
  • Intravitreal Injections
  • Klebsiella Infections / diagnosis
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / isolation & purification*
  • Levofloxacin / therapeutic use
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use
  • Prostatic Diseases / diagnosis
  • Prostatic Diseases / drug therapy
  • Prostatic Diseases / microbiology*
  • Retinal Vasculitis / diagnosis
  • Retinal Vasculitis / drug therapy
  • Retinal Vasculitis / microbiology*
  • Tomography, X-Ray Computed
  • Visual Acuity
  • Vitrectomy

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Levofloxacin
  • Ceftazidime
  • Prednisolone