Bilateral Endogenous Endophthalmitis as an Initial Presentation of Klebsiella pneumoniae Bacteremia in Advanced Hepatocellular Carcinoma
Journal Title: Ophthalmology Research: An International Journal - Year 2015, Vol 4, Issue 1
Abstract
Aims: To report a case of Klebsiella pneumoniae bacteremia presenting as bilateral endogenous endophthalmitis in a patient with advanced hepatocellular carcinoma and liver failure. Presentation of Case: We describe a 55 year-old man with diabetes, Hepatitis B, metastatic hepatocellular carcinoma with liver failure who presented with sudden, painful, bilateral rapid loss of vision accompanied with hypopyon, intense anterior chamber fibrinous reaction and vitritis. Systematic workup revealed bilateral endogenous K. pneumonia endophthalmitis secondary to hepatobiliary sepsis. Conservative management with systemic piperacillin/tazobactam, intravitreal and topical ceftazidime and vancomycin led to successful sepsis control, however visual outcome was dismal. Discussion: Klebsiella endogenous endophthalmitis has become extremely prevalent in southeast Asia, most commonly occurring as a metastatic complication of pyogenic liver abscess. Early systemic and intravitreal antibiotics remain the cornerstone of its management. Despite adequate treatment, visual prognosis is grave. Conclusion: This highlights the rapidly destructive nature of this virulent organism. Clinicians must be mindful that endophthalmitis can be the initial presenting sign of Klebsiella bacteremia and the search for a primary infective source is paramount. Identification of prognostic factors for poor vision following an attack allows early intervention, in hope to improve patient outcomes.
Authors and Affiliations
Rhuen Chiou Chow, Tengku Ain Kamalden
Keywords
Related Articles
- EP ID EP338917
- DOI 10.9734/OR/2015/17730
- Views 76
- Downloads 0
Risk Factors for the Development of Inpatient Exposure Keratitis
Purpose: To identify the risk factors for inpatient exposure keratitis and make possible the development of improved educational tools for providers. Methods: Retrospective chart review of inpatient ophthalmology consult...
Comparison of Phaco Energy and Complications for Conventional Phacoemulsification and 25-gauge Phacovitrectomy Surgery
Aim: To compare cumulative dissipated energy (CED), intraoperative and postoperative complications in eyes underwent conventional phacoemulsification and 25-Gauge phacovitrectomy surgery. Study Design: Retrospective, com...
Relationship between Petrochemical Pollution and Oculo-Visual Health in Onelga Region of the Niger Delta
Common sense and simple economics suggest that countries endowed with an abundance of natural resources should prosper. Yet over many years, it has been observed that developing nations rich in oil, gas or mineral resour...
Perimetry Comparisons for Octopus G Top and Dynamic Programmes versus Humphrey 24-2 SITA Fast and SITA Standard Programmes
Aims: Previous comparisons of Octopus and Humphrey threshold programmes have shown differences, particularly for depth of defects. Recent developments have altered the Octopus background illumination. Thus, we sought to...
Photochemical Kinetic Modeling for Oxygen-enhanced UV-light-activated Corneal Collagen Crosslinking
Aims: To derive analytic formulas for the efficacy of type-II corneal collagen crosslinking (CXL) based on coupled macroscopic kinetic equations with an emphasis on the role of oxygen. Study Design: modeling and analysi...