A Case of Klebsiella pneumoniae Meningitis Associated with Brain Abscess and Endophthalmitis

Meningitis, brain abscess, and endophthalmitis are rare manifestations of K. pneumoniae infection. We present a case of Klebsiella meningitis associated with a brain abscess and endophthalmitis. A 58-year-old man with alcoholic liver cirrhosis and hepatocellular carcinoma presented with fever, pain in the right eyeball, and vision loss. Endophthalmitis and urinary tract infections were identified through ophthalmologic examination and urine analysis, respectively, and empirical antibiotic therapy was administered. Approximately seven days after treatment, the patient presented with persistent headaches. In the cerebrospinal fluid study, the white blood cell count was 210/mm3, the protein level was 540 mg/dL, and the glucose level was 28.6 mg/ dL. Magnetic resonance imaging of the brain revealed diffuse brain abscesses in both hemispheres. Klebsiella pneumoniae was isolated from the blood and urine cultures. After intravenous injection of antibiotics (vancomycin and ceftriaxone) for 2 months, the headache resolved and the results of the cerebrospinal fluid study were normal.