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A rare case of concomitant Klebsiella pneumonia and panophthalmitis in a poorly controlled diabetic patient: the first case report from Syria

Authors
  • Kashkash, Mohamad F.1, 2
  • Douba, Zain1, 3, 4
  • Kaddour, Samer H.1, 5
  • Khouri, Abdulla1, 2
  • 1 Faculty of Medicine
  • 2 Pulmonology
  • 3 CME Office, Faculty of Medicine, University of Aleppo
  • 4 Department of Hematology, Zahi Azrak Hospital, Ministry of Health Syria
  • 5 Laboratory Medicine, Aleppo University Hospital, Aleppo, Syria
Type
Published Article
Journal
Annals of Medicine and Surgery
Publisher
Elsevier BV
Publication Date
Apr 12, 2023
Volume
85
Issue
4
Pages
913–917
Identifiers
DOI: 10.1097/MS9.0000000000000011
PMID: 37113923
PMCID: PMC10129237
Source
PubMed Central
Keywords
Disciplines
  • Case Reports
License
Unknown

Abstract

Diabetes mellitus is the most common endocrine metabolic disease. Uncontrolled diabetes affects almost all components of immunity. Diabetes mellitus patients have an increased susceptibility to infections which aggravates in the cases of uncontrolled hyperglycemia. Case presentation: The authors present the case of a 63-year-old female patient with a history of poorly controlled type 2 diabetes. She went to the ambulance complaining of fever, poor appetite, dyspnea, cough, fatigue, and asthenia. The chest computed tomography showed the presence of bilateral ovoid infiltration densities, mostly on the upper-right side. The initial diagnosis was community-acquired pneumonia in an immunocompromised host due to poorly controlled diabetes. A swelling was observed in the right cheek and around the right eye, along with ptosis of the right eyelid. The ophthalmologist indicated the presence of panophthalmitis of the entire right eye with optic neuritis and right orbital cellulitis. The bacterial culture of bronchoalveolar lavage showed Gram-negative bacteria known as Klebsiella . After 17 days of hospitalization, the patient was discharged from the hospital on treatment with oral fluconazole, oral ciprofloxacin, and intramuscular gentamicin. Conclusion: In conclusion, the case highlights the importance of early detection of systematic infection manifestations in diabetic patients, regarding their age, history, and other comorbidities. Ocular symptoms are highly recommended to be evaluated in this context of Klebsiella infection.

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