1. Hypermucoviscous capsular 1 (K1) serotype Klebsiella pneumoniae necrotising fasciitis and metastatic endophthalmitis
- Author
-
Edsel Maurice T Salvana, Christian Francisco, Manuel Jorge, Racquel Gorgonio Bruno, and Harold Henrison C. Chiu
- Subjects
0301 basic medicine ,Pars plana ,Male ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,030106 microbiology ,Necrotising fasciitis ,Vitrectomy ,Unusual Association of Diseases/Symptoms ,Hypopyon ,Serogroup ,Amputation, Surgical ,03 medical and health sciences ,0302 clinical medicine ,Endophthalmitis ,medicine ,Humans ,030212 general & internal medicine ,Fasciitis, Necrotizing ,Foot Injuries ,Gangrene ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,eye diseases ,Surgery ,Klebsiella Infections ,Klebsiella pneumoniae ,medicine.anatomical_structure ,Amputation ,sense organs ,medicine.symptom ,business ,Subcutaneous emphysema - Abstract
A 48-year-old man presented with a non-healing wound on his left foot after stepping on a nail. He self-medicated with amoxicillin, but the wound progressed prompting consult. On examination, his left foot was diffusely swollen with surrounding erythema, areas of gangrene, foul-smelling purulent discharge and subcutaneous emphysema. He was managed as a case of necrotising fasciitis and underwent emergent amputation. Three days after amputation, he developed a sudden and progressive blurring of vision, swelling and conjunctival erythema, with purulent discharge and the presence of hypopyon on the left eye. He was then managed as a case of endophthalmitis of the left eye and underwent pars plana vitrectomy. All cultures (blood, tissue and vitreous fluid) grew pan-susceptible hypermucoviscous Klebsiella pneumoniae, with positive string tests and confirmed by multilocus gene sequencing and sequence type analysis. He gradually improved with intravenous antibiotics, but only regained light perception in the left eye.
- Published
- 2018