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Klebsiella pneumoniae liver abscess with endophthalmitis in a diabetic man with gallstones
  1. Michael David1,
  2. Anna Louise Pouncey1,
  3. Rajab Kerwat2 and
  4. Sami Habal3
  1. 1General Surgery, Queen Elizabeth Woolwich, London, UK
  2. 2Surgery, Queen Elizabeth Woolwich, London, UK
  3. 3Ophthalmology, Queen Mary's Hospital, Sidcup, Kent, UK
  1. Correspondence to Dr Michael David; michael.david3{at}


Invasive liver abscess syndrome (ILAS) is caused by Klebsiella pneumoniae and is typically seen in people from East Asia, often with diabetes and gallstones. ILAS includes metastatic sequelae of the infection, commonly to the eyes. The case described below occurred in a London hospital. The patient’s abscess was diagnosed on CT and MRI and he developed endophthalmitis secondary to metastatic spread of the infection. He was treated with intravenous and intravitreal antibiotics and discharged with a plan for vitrectomy and cholecystectomy as an outpatient. We discuss the epidemiology, risk factors, pathogenesis, prognosis and management of this rare condition. There have been a number of recent reports of cases of this nature outside of Asia and we believe greater awareness is required. A high index of suspicion should be held for the potential development of metastases in patients of this demographic presenting with abscesses of this nature.

  • general surgery
  • infection (gastroenterology)
  • infectious diseases
  • ophthalmology

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  • Contributors RK: planning, conduct/clinical care, interpretation of case and writing/editing. SH: planning, conduct/clinical care, acquisition of images, writing/editing. ALP: planning, conduct/clinical care, interpretation of case, reporting, conception and design, and writing/editing. MD: planning, conduct/clinical care, data and image collection, interpretation of case, reporting, conception and design, and writing/editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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