A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess
Introduction: This case report presents a rare instance of hypervirulent Klebsiella pneumoniae invasive syndrome (KPIS) without hepatic involvement. It highlights an atypical presentation as this syndrome is characterized by liver abscesses. Case Presentation: A 54-year-old female of South Asian des...
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2024-10-01
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| Series: | European Journal of Case Reports in Internal Medicine |
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| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4927 |
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| author | Ghazal Talal Saeed Montaser Nabeeh Al Smady Gunjan Awatramani Hessa Alqasimi Mohammed Amaan Khokar Mohamed Awad Khadija Hafidh |
| author_facet | Ghazal Talal Saeed Montaser Nabeeh Al Smady Gunjan Awatramani Hessa Alqasimi Mohammed Amaan Khokar Mohamed Awad Khadija Hafidh |
| author_sort | Ghazal Talal Saeed |
| collection | DOAJ |
| description | Introduction: This case report presents a rare instance of hypervirulent Klebsiella pneumoniae invasive syndrome (KPIS) without hepatic involvement. It highlights an atypical presentation as this syndrome is characterized by liver abscesses.
Case Presentation: A 54-year-old female of South Asian descent presented to the emergency department with abdominal pain, fever, chills, nausea, and vomiting. Lab investigations showed hyperglycaemia, leukocytosis, and elevated procalcitonin. Imaging revealed bilateral acute pyelonephritis with early abscess formation in the left kidney, bilateral pleural effusions, diffuse multi-lobar consolidations, minimal ascites, and left renal vein thrombosis. The patient was treated as a case of septic shock secondary to hypervirulent K. pneumoniae with complications evolving into acute pyelonephritis and endogenous endophthalmitis. K. pneumoniae, known for its polysaccharide capsule, can lead to severe complications in immunocompromised patients, such as endogenous endophthalmitis, liver abscess, and pyelonephritis. Endophthalmitis, a critical ocular emergency, can result in permanent vision loss. The patient’s ocular outcomes remain uncertain due to a lack of follow-up, but prompt interdisciplinary intervention led to the resolution of other comorbidities.
Conclusion: This case highlights the importance of considering hypervirulent K. pneumoniae as a cause of severe infection without liver abscess. It also underscores the importance of immediate multidisciplinary management to address the systemic complications associated with this infection and the importance of connecting different symptoms to one aetiology. |
| format | Article |
| id | doaj-art-54cfd988986d466ebfa7183ed45f11d8 |
| institution | OA Journals |
| issn | 2284-2594 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-54cfd988986d466ebfa7183ed45f11d82025-08-20T02:26:38ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942024-10-0110.12890/2024_0049274462A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscessGhazal Talal Saeed0Montaser Nabeeh Al Smady1Gunjan Awatramani2Hessa Alqasimi3Mohammed Amaan Khokar4Mohamed Awad5Khadija Hafidh6College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab EmiratesCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab EmiratesCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab EmiratesCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab EmiratesCollege of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab EmiratesInternal Medicine Department, Rashid Hospital, Dubai Health, Dubai, United Arab EmiratesInternal Medicine Department, Rashid Hospital, Dubai Health, Dubai, United Arab EmiratesIntroduction: This case report presents a rare instance of hypervirulent Klebsiella pneumoniae invasive syndrome (KPIS) without hepatic involvement. It highlights an atypical presentation as this syndrome is characterized by liver abscesses. Case Presentation: A 54-year-old female of South Asian descent presented to the emergency department with abdominal pain, fever, chills, nausea, and vomiting. Lab investigations showed hyperglycaemia, leukocytosis, and elevated procalcitonin. Imaging revealed bilateral acute pyelonephritis with early abscess formation in the left kidney, bilateral pleural effusions, diffuse multi-lobar consolidations, minimal ascites, and left renal vein thrombosis. The patient was treated as a case of septic shock secondary to hypervirulent K. pneumoniae with complications evolving into acute pyelonephritis and endogenous endophthalmitis. K. pneumoniae, known for its polysaccharide capsule, can lead to severe complications in immunocompromised patients, such as endogenous endophthalmitis, liver abscess, and pyelonephritis. Endophthalmitis, a critical ocular emergency, can result in permanent vision loss. The patient’s ocular outcomes remain uncertain due to a lack of follow-up, but prompt interdisciplinary intervention led to the resolution of other comorbidities. Conclusion: This case highlights the importance of considering hypervirulent K. pneumoniae as a cause of severe infection without liver abscess. It also underscores the importance of immediate multidisciplinary management to address the systemic complications associated with this infection and the importance of connecting different symptoms to one aetiology.https://www.ejcrim.com/index.php/EJCRIM/article/view/4927hypervirulentklebsiella pneumoniaeklebsiella pneumoniae invasive syndromeendogenous endophthalmitis |
| spellingShingle | Ghazal Talal Saeed Montaser Nabeeh Al Smady Gunjan Awatramani Hessa Alqasimi Mohammed Amaan Khokar Mohamed Awad Khadija Hafidh A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess European Journal of Case Reports in Internal Medicine hypervirulent klebsiella pneumoniae klebsiella pneumoniae invasive syndrome endogenous endophthalmitis |
| title | A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| title_full | A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| title_fullStr | A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| title_full_unstemmed | A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| title_short | A unique case of hypervirulent Klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| title_sort | unique case of hypervirulent klebsiella pneumoniae invasive syndrome with endogenous endophthalmitis and left renal vein thrombosis without liver abscess |
| topic | hypervirulent klebsiella pneumoniae klebsiella pneumoniae invasive syndrome endogenous endophthalmitis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4927 |
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