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: Case report  Norway

[In Press] Severe Retinal Necrosis Due to Klebsiella pneumoniae After Acute Prostatitis

Unusual clinical course, Challenging differential diagnosis, Unusual setting of medical care, Rare disease, Rare coexistence of disease or pathology

Filippo Confalonieri123ACDEF, Bo┼ża Gorenjak de Souza4B, Goran Petrovski125ADEF, Xhevat Lumi42ACDEFG

Am J Case Rep In Press; DOI:   :: ID: 937512

Available online: , In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


We report a rare case of unilateral Klebsiella pneumoniae endogenous endophthalmitis with retinal necrosis secondary to acute prostatitis and its clinical management.
A 72-year-old immunocompetent male presented with high fever and gastrointestinal and genitourinary symptoms. He was diagnosed with acute prostatitis, hospitalized, and started on a systemic antibiotic. After 3 days, he experienced floaters in the right eye with subsequent loss of vision. He was referred to the ophthalmology department, where endophthalmitis was diagnosed. The patient underwent complete pars plana vitrectomy (PPV); vitreous samples were taken, and intravitreal antibiotics were injected. Intraoperatively, the retina appeared moderately ischemic, with signs of vasculitis and an area of infiltrated retina temporal to the central fovea. The microbiology results from the vitreous samples showed Klebsiella pneumoniae presence. After 9 days, rhegmatogenous retinal detachment ensued and the patient underwent phacoemulsification + intraocular lens implantation in the capsular bag, a second PPV, and silicone oil tamponade. Temporal to the fovea, a large area of retinal necrosis was observed. After a 10-month followup period, the silicone oil was removed, and subsequently, visual acuity improved, while the retina remained attached.
Klebsiella pneumoniae can be an aggressive microorganism that can cause retinal necrosis and compromise visual function. Prompt PPV can lead to some preservation of vision. This case demonstrates that a second PPV can prove to be a good therapeutic solution and should not be delayed.

Keywords: Endophthalmitis; Klebsiella pneumoniae; Ophthalmology; Prostatitis; Retina


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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923