Klebsiella pneumoniae Brain Abscess and Endophthalmitis after Acute Epiglottitis

Klebsiella pneumoniae is an unusual cause of brain abscess. Among the few cases of Klebsiella pneumoniae brain abscess that have been reported, most were associated with another underlying primary focus of infection. Endogenous endophthalmitis caused by Klebsiella pneumoniae is an infrequent but often devastating septic metastatic infection. We report a rare case of Klebsiella pneumoniae brain abscess and endophthalmitis after acute epiglottitis.

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Hypervirulent Klebsiella pneumoniae Endogenous Endophthalmitis—A Global Emerging Disease

Life ◽

10.3390/life11070676 ◽

2021 ◽

Vol 11 (7) ◽

pp. 676

Author(s):

Dragos Serban ◽

Alina Popa Cherecheanu ◽

Ana Maria Dascalu ◽

Bogdan Socea ◽

Geta Vancea ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Therapeutic Approach ◽

Fourth Generation ◽

Endogenous Endophthalmitis ◽

Severe Visual Loss ◽

Antibiotic Resistance Profile ◽

Focus Of Infection ◽

Pars Plana ◽

Primary Focus ◽

Associated Risk Factors

The review aims to document the new emerging hypervirulent Klebsiella pneumoniae (Kp) endogenous endophthalmitis (EKE) in terms of incidence, microbiological characterization of the pathogenic agent, associated risk factors, management, and outcomes. Hypervirulent (hv) strains of KP (hvKp) induce invasive liver abscesses (LA) with specific clinical features. Up to 80–90% of cases have hepatic liver abscess as a primary focus of infection, followed by renal or lung hvKp infections. However, the incidence of EKE in patients with KPLA varied between 3.4% (19) and 12.6% (13), with a total of 95 cases of endophthalmitis in 1455 cases of KPLA (6.5%). Severe visual loss was encountered in 75% of cases, with 25% bilateral involvement. Intravitreal antibiotics are the mainstay therapeutic approach. Pars plana vitrectomy is a subject of controversy. HvKp strains present mostly natural “wild-type” antibiotic resistance profile suggestive for community-acquired infections, being highly susceptive to the third and fourth generation of cephalosporins and carbapenems. Antimicrobial resistance in hypervirulent strains was recently documented via plasmid transfer and may result in extremely difficult to treat cases. Global dissemination of these strains is a major epidemiologic shift that should be considered in the diagnostic and therapeutic management of patients with endogenous endophthalmitis. Ophthalmologic screening in patients with KPLA and other hvKp infections and a multidisciplinary therapeutic approach is extremely important for early diagnosis and preservation of the visual function.

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Renal Abscesses and Endogenous Endophthalmitis due to Hypermucoviscous Hypervirulent Klebsiella pneumoniae (HVKP)

IDCases ◽

10.1016/j.idcr.2021.e01130 ◽

2021 ◽

pp. e01130

Author(s):

Fadi Hassanin ◽

Dareen Khawjah ◽

Sahar Elkhamary ◽

Hailah Al Hussain

Keyword(s):

Klebsiella Pneumoniae ◽

Endogenous Endophthalmitis

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Bacterial Infection and Splenic Reticuloendothelial Function in Children with Hemoglobin SC Disease

PEDIATRICS ◽

10.1542/peds.72.1.93 ◽

1983 ◽

Vol 72 (1) ◽

pp. 93-98

Author(s):

George R. Buchanan ◽

Susan J. Smith ◽

Christine A. Holtkamp ◽

John P. Fuseler

Keyword(s):

Bacterial Infection ◽

Bacterial Infections ◽

Infection Risk ◽

Bacterial Disease ◽

Normal Children ◽

Splenic Function ◽

Focus Of Infection ◽

Serious Bacterial Infections ◽

Primary Focus ◽

Hemoglobin Sc Disease

Although the epidemiology and pathophysiology of serious bacterial infection in homozygous sickle cell anemia (SS disease) have become increasingly well understood, information about infection risk and splenic reticuloendothelial function in hemoglobin SC disease is quite limited. Therefore, the type and frequency of invasive bacterial disease were examined in 51 children with SC disease followed for 370 person-years and splenic function was assessed in 31 patients by quantitation of pitted erythrocytes. Seven serious bacterial infections occurred in four of the patients, five due to Streptococcus pneumoniae and two to Haemophilus influenzae. A primary focus of infection was present in all episodes, none of which proved fatal. Although 30 episodes of pneumonia or chest syndrome occurred in 20 of the patients, a bacterial etiology was proven in only three instances. Splenic function was usually impaired, with a mean pit count of 7.1% ± 8.2% (range 0% to 22.9%). This is significantly greater than normal, but less than pit counts in patients with SS disease or asplenic subjects. Children with SC disease may have a greater risk of bacterial infection than normal children, but their infection rate is not nearly as high as that in patients with SS disease.

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Klebsiella pneumoniae liver abscess complicated by endogenous endophthalmitis: the importance of early diagnosis and intervention

The Medical Journal of Australia ◽

10.5694/mja15.00107 ◽

2015 ◽

Vol 203 (7) ◽

pp. 300-301 ◽

Cited By ~ 1

Author(s):

Phoebe P Moore ◽

Gerard F McGowan ◽

Sukhpal S Sandhu ◽

Penelope J Allen

Keyword(s):

Early Diagnosis ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Endogenous Endophthalmitis

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A case of death within 72 hours after community-acquired bloodstream infection caused by klebsiella variicola

10.21203/rs.3.rs-201872/v1 ◽

2021 ◽

Author(s):

Dali Long ◽

Yuhui Wang ◽

Jinlong Wang ◽

Sijie Mu ◽

Li Chen ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Rare Case ◽

Bacterial Culture ◽

Drug Susceptibility ◽

Klebsiella Pneumonia ◽

Gene Detection ◽

Laboratory Methods ◽

Short Period ◽

Genetic Detection ◽

Illness Progression

Abstract Klebsiella subspecies infection is widely misdiagnosed and underestimated in clinic. We report a patient who was admitted to hospital due to unknown high fever. Bacterial culture only revealed the klebsiella pneumonia. Broad-spectrum antibiotics failed to improve patient's symptoms, although these antibiotics are sensitive to klebsiella pneumonia according to the drug susceptibility results. Patient rapidly entered sepsis and subsequent sepsis shock, and died within 72 hours. The delayed PMseq-DNA Pro high throughput gene detection revealed the mixed infection of klebsiella pneumoniae and klebsiella variicola. This is a very rare case that patient suffered so rapid deterioration and died from bacterial infection within short period of time. Klebsiella variicola could contribute to rapid illness progression, while it was revealed by gene detection rather than classic laboratory methods. Which suggests that early genetic detection should be recommended in cases of complex infection.

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IDENTIFICATION MARKERS OF INFECTION DUE TO C. TRACHOMATIS AND C. PNEUMONIAE, IN PATIENTS WITH DISEASES OF THE GASTROINTESTINAL TRACT

Russian Journal of Infection and Immunity ◽

10.15789/2220-7619-2018-3-316-324 ◽

2018 ◽

Vol 8 (3) ◽

pp. 316-324

Author(s):

N. E. Bondareva ◽

E. Yu. Morgunova ◽

N. A. Zigangirova ◽

Yu. G. Shapkin ◽

Yu. V. Chalyk ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Blood Serum ◽

Chlamydial Infection ◽

Simultaneous Detection ◽

Gastrointestinal Diseases ◽

Infectious Period ◽

Gastrointestinal Pathology ◽

Causative Agents ◽

Focus Of Infection ◽

Primary Focus

To date, clinical data have convincingly shown that C. trachomatis and C. pneumoniae infectious can cause serious diseases with severe complications and consequences. There are assumptions that the developed chronic chlamydial infection can become an important factor in the pathogenesis of the gastrointestinal tract diseases, which are manifested in the so-called post-infectious period. It is commonly known that chlamydial infection has a tropism to the cylindrical epithelium, which covers the human mucous membrane of the urethra, cervix, rectum, conjunctiva of the eyes and the throat. However, the role of the causative agents of chlamydial infections, such as C. trachomatis and C. pneumoniae, in the occurrence of the gastrointestinal tract diseases has not been studied. In order to study the possible relationship between the gastrointestinal diseases and the presence of chlamydial infection markers, we have selected a group of patients with the gastrointestinal diseases and detected antibodies to C. trachomatis and C. pneumoniae and DNA of these pathogens in blood serum, liver biopsy and bile ducts. As a result, C. trachomatis DNA in blood serum was detected in 50% of cases, and in liver biopsies — in 59.3%. A new approach has been developed in the serological diagnosis of chlamydial infection caused by C. trachomatis, which allowed for revealing diagnostic antibody titers in 51.9% of cases in this group of patients, and in the comparison group — in 11.6% of cases. Among 50% of patients, in whom DNA was revealed in blood serum, it was also revealed in 64.3% of cases in biopsy samples of gastrointestinal organs. Upon detection of C. trachomatis DNA in blood serum, antibodies to the “cultural” antigen were detected in 60.1% of cases, and with the simultaneous detection of C. trachomatis DNA in blood serum and gastrointestinal organs, they were found in 72.2% of cases. Simultaneous detection of C. trachomatis, both in blood serum and in the gastrointestinal tract, may indicate the ability of C. trachomatis to spread hematogenously and infect organs away from the primary focus of infection. The obtained data absolutely require further study in light of the identification of the relationship between the detection of the pathogen and the development of the gastrointestinal pathology. But in general, the results are not yet studied evidence of the possible gastrointestinal organs infection by C. trachomatis.

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