Endogenous Endophthalmitis Due to Klebsiella ozaenae

PURPOSE: To report a case of endogenous endophthalmitis due to Klebsiella ozaenae, which is a rare causative organism of endophthalmitis. CASE SUMMARY: A 61-year-old male who was undergoing chemotherapy for hepatocellular carcinoma complained of sudden visual loss and ocular pain in his left eye for 2 days. On the first examination, the patient's visual acuity was counting fingers at 10 cm and the intraocular pressure was elevated to 29 mm Hg. Partial scleral rupture and choroidal prolapse were observed. Subretinal abscess was detected with increased echogenicity using ultrasonography. The patient complained of burning sensation on voiding and urinary frequency; subsequent urinalysis showed pyuria and bacteriuria. Intravitreal and systemic antibiotics were administered under the impression of endogenous endophthalmitis caused by urinary tract infection. Despite treatment, visual acuity decreased to no light perception in 4 days and intraocular pressure and pain was uncontrollable. Enucleation was performed and pus culture from the eye during surgery revealed Klebsiella ozaenae. CONCLUSIONS: Klebsiella ozaenae is a rare causative organism of endophthalmitis and shows a rapid progress and poor prognosis. Endogenous endophthalmitis must be highly suspected in patients with urinary tract infection as well as pyogenic liver abscess.

In vitro Bacteriostatic Effect of a Scaffold with a Mixture of Hypericum perforatum and Azadirachta indica Oil Extracts.

Background: Clinical evidences suggest antimicrobial activities of a new oil extract mixture of Hypericum perforatum and Azadirachta indica, included in a polymeric scaffold (or Hyperoil™ Polimeric Substrate - HPS). Methods: Bacteriostatic activity was investigated on selected strains of Staphylococcus aureus (ATCC® 12598™), Pseudomonas aeruginosa (ATCC® 10145™) and Klebsiella ozaenae AM through standardized in vitro tests. Results and Conclusion: All bacterial strains were stabilized or reduced in size after 3 and 24 hours contact with the HPS if compared to the empty polymeric scaffolds. Results showed the bacteriostatic effect of HPS that, added with its anti-inflammatory properties, could explain its tissue repair effects observed in vivo.

Klebsiella ozaenae sepsis in a young healthy male

Introduction: K. ozaenae is a weak pathogenic organism known to cause primary atrophic rhinitis or ozena. There are few reports that the bacteria could cause serious invasive infection in debilitated patients. This is fi rst report of K. ozaenae in a young previously healthy adult. Case presentation: A 34-year-old Filipino male with no signifi cant previous medical history presented with severe frontal headache of two days duration with fever and chills. Blood and serum work-up showed leukocytosis, mild thrombocytopenia, hypomagnesemia, hypokalemia, and hypophopatemia. Liver function test indicated elevated bilirubin and transaminases. CT of the head indicated sinus disease including mucoperiosteal-like thickening of the right maxillary sinus, left mastoid hypoaeration and sclerosis characteristics of chronic infl ammation. Blood culture grew gram negative rods identifi ed as Klebsiella ozaenae species. Conclusion: Klebisella ozaenae sepsis is rarely reported in medical literature. There are about 12 case reports all of which identifi ed with one or more chronic conditions causing decline in patient immunity resulting in invasive infection by the weak pathogen. Our patient is a young physically active adult male with no identifi able risk factors except chronic ozena-like infection that might serve as a source for haematologic seeding.

A mimicry of melioidosis by Klebsiella ozaenae infection

Klebsiella ozaenae is a Gram negative bacillus. It has been described as a colonizer of oral and nasopharyngeal mucosa and is a cause of atrophic rhinitis. Klebsiella ozaenae has seldom been isolated from serious infections. However, several reports have stated that Klebsiella ozaenae may cause invasive infections and even mortality. We report a 55-year-old man with Klebsiella ozaenae infection causing abscesses involving the right eye and left kidney and possibly also in the brain, lungs and prostate. The isolates were sensitive to ceftazidime, ciprofl oxacin, chloramphenicol, gentamicin and sulfamethoxazole-trimethoprim but resistant to ampicillin. He responded well to 4 weeks of IV ceftazidime and IV amoxycillin-clavulanic acid. To our knowledge, such a multiorgan infection has not been reported previously for this organism.