జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

First Case of Liver Abscess with Endogenous Endophthalmitis due toNon- K1/K2 Serotype Hypermucoviscous Klebsiella pneumoniae Clone ST268

Yuji Hirai, Sayaka Asahata-Tago, Yusuke Ainoda, Takahiro Fujita, Yutaka Uzawa, Kaori Yamamoto, Tomohiro Iida, Ken Kikuchi

The hypermucoviscous (hv) Klebsiella pneumoniae (KP) can cause invasive liver abscess syndrome (ILAS) including endophthalmitis dominantly in eastern Asia. We report a 80-years old woman who diagnosed with invasive liver abscess syndrome due to K. pneumoniae (KP) non-K1/K2 hvKP multi-locus sequence type ST268 by DNA amplification methods isolated from blood culture. Soon she developed endogenous endopththalmitis and immediately right vitrectomy was performed. Although intravenous 2g of ceftriaxone (CTRX) was administrated, total enucleation of right eyeball had performed due to orbital cellulitis and necrosis of eye ball finally. To find complication (i.e. endophthalmitis) with caution and to select antimicrobial agents with sufficient penetration to CNS (i.e. ceftriaxone) is needed in a patient with severe hvKP infection. Usually ILAS is caused by K1/K2 hvKP. However, to our knowledge, this is a first report of ILAS with endophthalmitis and orbital cellulitis due to non-K1/K2 hvKP ST268.