Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Oct 19:23:e937512.
doi: 10.12659/AJCR.937512.

Severe Retinal Necrosis Due to Klebsiella pneumoniae After Acute Prostatitis

Filippo Confalonieri  1   2   3 , Boža Gorenjak de Souza  4 , Goran Petrovski  1   2   5 , Xhevat Lumi  2   4
Affiliations
Case Reports

Severe Retinal Necrosis Due to Klebsiella pneumoniae After Acute Prostatitis

Filippo Confalonieri et al. Am J Case Rep. .

Abstract

BACKGROUND We report a rare case of unilateral Klebsiella pneumoniae endogenous endophthalmitis with retinal necrosis secondary to acute prostatitis and its clinical management. CASE REPORT 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. CONCLUSIONS 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.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1.
Figure 1.
Postoperative right eye showing silicone oil in the vitreous cavity, flat retina, and an extensive necrotic retinal area temporal to the macula (arrow).
Figure 2.
Figure 2.
Ten-month postoperative optical coherence tomography scan passing through the fovea showing the atrophic retina (arrow).
Figure 3.
Figure 3.
Ten-month postoperative fundus image showing flat retina with an extensive, stable, temporal area of necrotic retina (arrow).
Video 1.
Video 1.
Endophthalmitis with retinal necrosis.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Mamalis N. Endophthalmitis. J Cataract Refract Surg. 2002;28(5):729–30. - PubMed
    1. Vaziri K, Schwartz SG, Kishor K, Flynn HW. Endophthalmitis: State of the art. Clin Ophthalmol. 2015;9:95–108. - PMC - PubMed
    1. Kernt M, Kampik A. Endophthalmitis: Pathogenesis, clinical presentation, management, and perspectives. Clin Ophthalmol. 2010;4:121–35. - PMC - PubMed
    1. Connell PP, O’Neill EC, Fabinyi D, et al. Endogenous endophthalmitis: 10-year experience at a tertiary referral centre. Eye (Lond) 2011;25(1):66–72. - PMC - PubMed
    1. Gurnani B, Kaur K. Endogenous endophthalmitis. StatPearls Publishing; 2021. [cited 2022 Jun 5]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK576391/ - PubMed

Publication types