Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl
The purpose of the study was to report a unique case of Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl. A 16-year-old girl presented with decreased vision in the right eye preceding an episode of fever with a rash associated with burning micturition. The patient was exami...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Taiwan Journal of Ophthalmology |
| Subjects: | |
| Online Access: | http://www.e-tjo.org/article.asp?issn=2211-5056;year=2023;volume=13;issue=1;spage=84;epage=87;aulast=Dhiman |
| _version_ | 1797866400535019520 |
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| author | Richa Dhiman Nancy Sharma Jyoti Chauhan |
| author_facet | Richa Dhiman Nancy Sharma Jyoti Chauhan |
| author_sort | Richa Dhiman |
| collection | DOAJ |
| description | The purpose of the study was to report a unique case of Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl. A 16-year-old girl presented with decreased vision in the right eye preceding an episode of fever with a rash associated with burning micturition. The patient was examined after taking appropriate consent. The slit-lamp examination revealed a ring-shaped corneal infiltrate with an epithelial defect in her right eye. Corneal scrapings were sent for microbiological evaluation which revealed Gram-negative rods and culture identified it as extended-spectrum beta-lactamase-producing Klebsiella pneumoniae colonies. The patient showed a good response to topical fortified amikacin and tobramycin. For her systemic complaints, the pediatrician did a thorough investigative workup out of which blood culture showed growth of K. pneumoniae. Hence, intravenous antibiotics were given based on the antibiogram report and the patient recovered. After 2 weeks, a paracentral infiltrate in her left eye was noted followed by anterior uveitis. The patient responded well to the topical course of steroids along with aminoglycosides. Four months later, she had a recurrence of anterior uveitis in the right eye preceded by fever. Blood investigations were negative. Hence, a diagnosis of recurrent uveitis secondary to endogenous infection was made and the patient was successfully treated with a short course of topical steroids. The patient is on follow-up for the past 6 months and maintaining the best-corrected visual acuity of 20/20 OU with normal intraocular pressure and quiet anterior chamber (AC). This is the first clinical report describing a ring infiltrate in endogenous Klebsiella keratitis and emphasizes thorough workup for prompt treatment. |
| first_indexed | 2024-04-09T23:24:38Z |
| format | Article |
| id | doaj.art-f19446fd87a64541ba70672d490aef55 |
| institution | Directory Open Access Journal |
| issn | 2211-5056 2211-5072 |
| language | English |
| last_indexed | 2024-04-09T23:24:38Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Taiwan Journal of Ophthalmology |
| spelling | doaj.art-f19446fd87a64541ba70672d490aef552023-03-21T11:27:43ZengWolters Kluwer Medknow PublicationsTaiwan Journal of Ophthalmology2211-50562211-50722023-01-01131848710.4103/tjo.TJO-D-22-00101Klebsiella keratitis presenting as a ring infiltrate in an adolescent girlRicha DhimanNancy SharmaJyoti ChauhanThe purpose of the study was to report a unique case of Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl. A 16-year-old girl presented with decreased vision in the right eye preceding an episode of fever with a rash associated with burning micturition. The patient was examined after taking appropriate consent. The slit-lamp examination revealed a ring-shaped corneal infiltrate with an epithelial defect in her right eye. Corneal scrapings were sent for microbiological evaluation which revealed Gram-negative rods and culture identified it as extended-spectrum beta-lactamase-producing Klebsiella pneumoniae colonies. The patient showed a good response to topical fortified amikacin and tobramycin. For her systemic complaints, the pediatrician did a thorough investigative workup out of which blood culture showed growth of K. pneumoniae. Hence, intravenous antibiotics were given based on the antibiogram report and the patient recovered. After 2 weeks, a paracentral infiltrate in her left eye was noted followed by anterior uveitis. The patient responded well to the topical course of steroids along with aminoglycosides. Four months later, she had a recurrence of anterior uveitis in the right eye preceded by fever. Blood investigations were negative. Hence, a diagnosis of recurrent uveitis secondary to endogenous infection was made and the patient was successfully treated with a short course of topical steroids. The patient is on follow-up for the past 6 months and maintaining the best-corrected visual acuity of 20/20 OU with normal intraocular pressure and quiet anterior chamber (AC). This is the first clinical report describing a ring infiltrate in endogenous Klebsiella keratitis and emphasizes thorough workup for prompt treatment.http://www.e-tjo.org/article.asp?issn=2211-5056;year=2023;volume=13;issue=1;spage=84;epage=87;aulast=Dhimanamikacinendogenous infectionextended-spectrum beta-lactamase-producingklebsiella keratitisring infiltratetobramycin |
| spellingShingle | Richa Dhiman Nancy Sharma Jyoti Chauhan Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl Taiwan Journal of Ophthalmology amikacin endogenous infection extended-spectrum beta-lactamase-producing klebsiella keratitis ring infiltrate tobramycin |
| title | Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| title_full | Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| title_fullStr | Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| title_full_unstemmed | Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| title_short | Klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| title_sort | klebsiella keratitis presenting as a ring infiltrate in an adolescent girl |
| topic | amikacin endogenous infection extended-spectrum beta-lactamase-producing klebsiella keratitis ring infiltrate tobramycin |
| url | http://www.e-tjo.org/article.asp?issn=2211-5056;year=2023;volume=13;issue=1;spage=84;epage=87;aulast=Dhiman |
| work_keys_str_mv | AT richadhiman klebsiellakeratitispresentingasaringinfiltrateinanadolescentgirl AT nancysharma klebsiellakeratitispresentingasaringinfiltrateinanadolescentgirl AT jyotichauhan klebsiellakeratitispresentingasaringinfiltrateinanadolescentgirl |