Sudden blindness at the age of 45, this high-risk infection is likely to target diabetic patients, Nanda First Affiliated Hospital NEJM published cases

▎WuXi AppTec content team editors In daily life, we cannot do without mobile phones, computers, TVs and other electronic products.
We often overuse our eyes without paying attention; sometimes we may experience dry eyes, eye pain, or even decreased vision, etc.
Discomfort
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In addition to excessive eye use, symptoms such as eye discomfort may also be a manifestation of bacterial infection
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Recently, one such Chinese case appeared in the New England Journal of Medicine (NEJM)
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A young and middle-aged man went to the doctor with pain in his left eye and decreased vision.
It was eventually discovered that the cause was infection with highly virulent Klebsiella pneumoniae
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After a period of treatment, although the patient recovered well in other conditions, the vision in the left eye was completely lost
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The corresponding author of the case report is Dr.
Li Yang from the Emergency Department of the First Affiliated Hospital of Nanchang University, and the first author is Dr.
Qiong Zou from the Eye Hospital of Nanchang University
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Screenshot source: A 45-year-old male from The New England Journal of Medicine came to the ophthalmology clinic due to pain in his left eye and decreased vision for 5 days
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Medical history: Suffered from type 2 diabetes
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Physical examination: body temperature 39.
2℃, pulse 144 beats/min
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Examination of the left eye showed diffuse conjunctival hyperemia, dense cataract, and lack of light perception (Figure A below)
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Because of concerns about endogenous endophthalmitis with systemic infection, the patient was referred to the emergency department
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A contrast-enhanced CT scan of the chest, abdomen, and pelvis was performed, showing abscesses in the lungs, liver (Figure B below), kidneys, and prostate
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Image source: Reference [1] The patient was treated with intravenous and intravitreal antibiotics, and received percutaneous drainage of liver and prostate abscess
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Klebsiella pneumoniae grew in blood, liver and prostate abscess pus and vitreous humor cultures, which were identified as highly virulent K1 serotype by polymerase chain reaction test
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During the hospital stay, the patient refused vitrectomy
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Returned to the clinic 2 months after seeing the doctor, and the left eye had recovered well but his vision was completely lost
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Klebsiella pneumoniae Klebsiella pneumoniae (Klebsiella pneumoniae) is a gram-negative bacteria that can naturally exist in the intestines and respiratory tracts of healthy individuals.
People with healthy immune systems rarely develop infections
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Highly virulent Klebsiella pneumoniae can infect healthy people and diabetic patients, mainly manifested as liver abscess with invasive infection of multiple sites, including liver, central nervous system, lung, urinary tract and soft tissues, namely invasive Klebsiella pneumoniae Liver abscess syndrome
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It is often accompanied by co-infection of multiple organ systems or bloodstream infections, leading to serious disabling and fatal incidents
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Related reading NEJM of the Third Hospital of Beijing Medical University published a case: itching of the eyelids in children was actually infected with lice! The woman had abdominal pain for two years, but her spleen grew out of her pelvis? The Zhejiang Provincial People’s Hospital team NEJM published a case where a fish cut the thumb, but it turned out to be bacterial infection and long nodular ulcers on both arms | NEJM case always blushes after taking a bath? Cases published in The Lancet of West China Hospital: Cases published in The Lancet of Zheng University First Affiliated Hospital: fever of unknown origin, infection identified by gene sequencing Source: 123RF reference materials [1] Zou Q, Li Y.
Hypervirulent Klebsiella pneumoniae .
N Engl J Med, doi: 10.
1056/NEJMicm2101602.
[2] Li Xingyu, Shen Chuan, Wang Yadong, et al.
Progress in diagnosis and treatment of liver abscess with Klebsiella pneumoniae (2021).
Chinese Journal of Infectious Diseases, 39(2) : 116-120.
DOI: 10.
3760/cma.
j.
cn311365-20191227-00428.
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This article is for the purpose of information exchange only.
The opinions expressed in the article do not represent the position of WuXi AppTec, nor does it mean that WuXi AppTec supports or opposes the views in the article
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This article is not a treatment recommendation either
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If you need guidance on the treatment plan, please go to a regular hospital for treatment
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