NOSOCOMIAL KLEBSIELLA-PNEUMONIAE CONJUNCTIVITIS RESULTING IN INFECTIOUS KERATITIS AND BILATERAL CORNEAL PERFORATION

Purpose. Klebsiella pneumoniae is a known cause of metastatic endophth almitis. However, the organism has never been described to cause sever e infectious keratoconjunctivitis. We report a fulminant case of nosoc omial K. pneumoniae conjunctivitis complicated by infectious keratitis and corneal perforation in both eyes. Methods. An 83-year-old previou sly healthy Chinese woman, blind in the right eye from rubeotic glauco ma and with bilateral dense cataracts, was admitted for observation af ter a head injury. While in hospital, she developed purulent bilateral conjunctivitis. Repeated cultures grew K. pneumoniae. This rapidly pr ogressed to severe infectious keratitis and corneal perforation in bot h eyes, despite intensive antibiotics to which the organism was suscep tible. The patient was otherwise well, and investigations did not reve al any source of endogenous sepsis. Results. The patient lost complete vision in both eyes. The left eye turned phthisical, and the right ey e was eviscerated for uncontrolled endophthalmitis. Conclusion. Althou gh not previously reported, K. pneumoniae can cause devastating kerato conjunctivitis resulting in corneal melt, perforation, and uncontrolle d endophthalmitis.