Endogenous endophthalmitis caused by Klebsiella pneumoniae secondary to prostatic abscess: a report of two cases.
Takanori Mochizuki, Norifumi Sawada, Yuichiro Nakamura et al.
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Case in brief
Two men developed endogenous endophthalmitis associated with Klebsiella pneumoniae prostatic abscesses. A 37-year-old presented with fever and lower urinary tract symptoms followed by acute visual loss; blood and urine cultures grew K. pneumoniae, and imaging showed a prostatic abscess and septic pulmonary embolism. The abscess resolved with systemic antibiotics without drainage, but severe visual impairment remained. A 68-year-old man with benign prostatic hyperplasia developed fever and visual disturbance; urine grew K. pneumoniae, and CT showed prostatic and liver abscesses. Progressive ocular inflammation, raised intraocular pressure, and severe pain led to enucleation.
What made this case unusual
The report draws attention to prostatic abscess as a primary focus of K. pneumoniae infection associated with endogenous endophthalmitis, a source described as rarely reported.
Diagnostic / clinical pearl
In a patient with K. pneumoniae infection and acute visual symptoms, consider a prostatic abscess as a possible distant infectious focus, even when another metastatic abscess is also present.
Why it matters
The cases illustrate that ocular involvement may leave severe visual impairment or require enucleation despite treatment, underscoring the importance of recognizing invasive infection and its source.