Endogenous endophthalmitis complicating Klebsiella pneumoniae liver abscess in Europe: case report

Purpose: To report the first European case of endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumoniae expressing MagA gene. Methods: A 33-year-old diabetic patient was admitted for fever and right upper quadrant abdominal pain. Abdominal computed tomography and laboratory studies were performed. On day 4 after admission, patient complained of a painful and red right eye with decreased vision. A complete ophthalmological examination, including visual acuity assessment, slit lamp examination and fundus ophthalmoscopy was started. Results: Klebsiella pneumoniae liver abscess was diagnosed and antibiotherapy initiated. Polymerase chain reaction revealed that the isolated Klebsiella pneumoniae was serotype K1 and positive for Mag A. Ophthalmological examination disclosed cells in the anterior chamber and an important vitritis. Fundus was barely visible. A diagnosis of Klebsiella pneumoniae endogenous endophthalmitis complicating liver abscess was made. Intravitreal injection of antibiotics resulted in a preservation of visual acuity. Conclusion: This report suggests that rather than being confined to Taiwan, endogenous endophthalmitis secondary to a liver abscess due to Klebsiella pneumoniae expressing MagA gene, is becoming a global problem.