Klebsiella pneumoniae liver abscess with endophthalmitis in a diabetic man with gallstones.

Michael David, Anna Louise Pouncey, Rajab Kerwat, Sami Habal

BMJ case reports 2021 Feb 26

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Invasive liver abscess syndrome (ILAS) is caused by Klebsiella pneumoniae and is typically seen in people from East Asia, often with diabetes and gallstones. ILAS includes metastatic sequelae of the infection, commonly to the eyes. The case described below occurred in a London hospital. The patient's abscess was diagnosed on CT and MRI and he developed endophthalmitis secondary to metastatic spread of the infection. He was treated with intravenous and intravitreal antibiotics and discharged with a plan for vitrectomy and cholecystectomy as an outpatient. We discuss the epidemiology, risk factors, pathogenesis, prognosis and management of this rare condition. There have been a number of recent reports of cases of this nature outside of Asia and we believe greater awareness is required. A high index of suspicion should be held for the potential development of metastases in patients of this demographic presenting with abscesses of this nature. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Citation

Michael David, Anna Louise Pouncey, Rajab Kerwat, Sami Habal. Klebsiella pneumoniae liver abscess with endophthalmitis in a diabetic man with gallstones. BMJ case reports. 2021 Feb 26;14(2)