Skip to main content

Advertisement

Log in

Fulminant endogenous Klebsiella pneumoniae endophthalmitis: imaging findings

  • Case Report
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

Endogenous endophthalmitis is a rare but serious complication of Klebsiella pneumoniae infection that has been predominantly reported to occur in diabetic patients of East Asian origin with K. pneumoniae liver abscesses. The clinical symptoms and signs of endogenous endophthalmitis are nonspecific and may mimic other causes of an acute non-traumatic eye. Permanent visual loss and blindness are common sequelae because of delayed diagnosis and treatment. Computed tomography and magnetic resonance imaging can help to differentiate endophthalmitis from other causes of acute non-traumatic eye when the clinical findings are equivocal. Fluid attenuated inversion recovery and diffusion-weighted imaging with apparent diffusion coefficient map are superior to T2-weighted and gadolinium-enhanced T1-weighted sequences in demonstrating intra-ocular abscesses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chee SP, Jap A (2001) Endogenous endophthalmitis. Curr Opin Ophthalmol 12:464–470

    Article  PubMed  CAS  Google Scholar 

  2. Tan YM, Chee SP, Soo KC et al (2004) Ocular manifestations and complications of pyogenic liver abscess. World J Surg 28:38–42

    Article  PubMed  Google Scholar 

  3. Lee CC, Chen CY, Chen FH et al (1998) Septic metastatic endophthalmitis from Klebsiella pneumoniae liver abscess: CT and MR imaging characteristics—report of three cases. Radiology 207:411–416

    PubMed  CAS  Google Scholar 

  4. Rumboldt Z, Moses C, Wieczerzynski U et al (2005) Diffusion-weighted imaging, apparent diffusion coefficients, and fluid-attenuated inversion recovery MR imaging in endophthalmitis. AJNR Am J Neuroradiol 26:1869–1872

    Google Scholar 

  5. Yu E, Laughlin S, Kassel EE et al (2005) Nocardial endophthalmitis and subretinal abscess: CT and MR imaging features with pathologic correlation: a case report. AJNR Am J Neuroradiol 26:1220–1222

    PubMed  Google Scholar 

  6. Okada AA, Johnson RP, Liles WC et al (1994) Endogenous bacterial endophthalmitis: report of a ten-year retrospective study. Ophthalmology 101:832–838

    PubMed  CAS  Google Scholar 

  7. Jackson TL, Eykyn SJ, Graham EM et al (2003) Endogenous bacterial endophthalmitis: a 17-year prospective series and review of 267 reported cases. Surv Ophthalmol 48:403–423

    Article  PubMed  Google Scholar 

  8. Han SH (1995) Review of hepatic abscess from Klebsiella pneumoniae. West J Med 162:220–224

    PubMed  CAS  Google Scholar 

  9. Wong JS, Chan TK, Lee HM et al (2000) Endogenous bacterial endophthalmitis: an east Asian experience and a reappraisal of a severe ocular affliction. Ophthalmology 107:1483–1491

    Article  PubMed  CAS  Google Scholar 

  10. Harris EW, D’Amico DJ, Bhisitkul R et al (2000) Bacterial subretinal abscess: a case report and review of the literature. Am J Ophthalmol 29:778–785

    Article  Google Scholar 

  11. Scott IU, Matharoo N, Flynn HW et al (2004) Endophthalmitis caused by Klebsiella species. Am J Ophthalmol 138:662–663

    Article  PubMed  Google Scholar 

  12. Lederman ER, Crum NF (2005) Pyogenic liver abscess with a focus on Klebsiella pneumoniae as a primary pathogen: an emerging disease with unique clinical characteristics. Am J Gastroenterol 100:322–331

    Article  PubMed  Google Scholar 

  13. Greenwald MJ, Wohl LG, Sell CH (1986) Metastatic bacterial endophthalmitis: a contemporary reappraisal. Surv Ophthalmol 31:81–101

    Article  PubMed  CAS  Google Scholar 

  14. Meyers-Elliott RH, Dethlefs BA (1982) Experimental Klebsiella-induced endophthalmitis in rabbits. Arch Ophthalmol 100:1959–1963

    PubMed  CAS  Google Scholar 

  15. Couez D, Libon E, Wasteels M et al (1991) Klebsiella pneumoniae liver abscess with septic endophthalmitis. J Belge Radiol 74:41–44

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Wai-Kit Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Seale, M., Lee, WK., Daffy, J. et al. Fulminant endogenous Klebsiella pneumoniae endophthalmitis: imaging findings. Emerg Radiol 13, 209–212 (2007). https://doi.org/10.1007/s10140-006-0550-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-006-0550-4

Keywords

Navigation