Dehghani A R, Masjedi A, Fazel F, Ghanbari H, Akhlaghi M, Karbasi N
Ophthalmology Ward, Feiz Hospital, University of Medical Science, Isfahan, Iran.
Case Rep Ophthalmol. 2011 Jan 7;2(1):10-4. doi: 10.1159/000323449.
To report the first case of endogenous Klebsiella endophthalmitis associated with liver abscess in Iran.
A 79-year-old man was referred to our hospital due to severe pain and visual loss in the left eye. On physical examination, conjunctival hyperemia, corneal edema, hypopyon and severe vitreous cellular reaction were identified in the left eye; however, yellowish conjunctival discoloration was more apparent in the right eye. Abdominal CT scan showed a right liver lobe abscess that was confirmed by sonographically guided percutaneous liver mass biopsy. Blood, vitreous and liver mass aspirate cultures revealed Klebsiella pneumoniae growth. The patient was thus diagnosed with endogenous Klebsiella endophthalmitis secondary to bacteremia associated with liver abscess.
This report suggests that, rather than being confined to Taiwan, endogenous endophthalmitis secondary to a liver abscess due to K. pneumoniae may be a global problem. Therefore, physicians should be aware of the possibility of endophthalmitis whenever a patient with K. pneumoniae liver abscess complains of ocular symptoms.
报告伊朗首例与肝脓肿相关的内源性克雷伯菌性眼内炎病例。
一名79岁男性因左眼剧痛和视力丧失转诊至我院。体格检查发现左眼结膜充血、角膜水肿、前房积脓和严重的玻璃体细胞反应;然而,右眼淡黄色结膜变色更明显。腹部CT扫描显示右肝叶脓肿,经超声引导下经皮肝肿物活检得以证实。血液、玻璃体和肝肿物抽吸物培养均显示肺炎克雷伯菌生长。因此,该患者被诊断为继发于与肝脓肿相关的菌血症的内源性克雷伯菌性眼内炎。
本报告表明,肺炎克雷伯菌所致肝脓肿继发的内源性眼内炎可能是一个全球性问题,而非仅限于台湾地区。因此,当肺炎克雷伯菌肝脓肿患者出现眼部症状时,医生应意识到眼内炎的可能性。