An Extremely Rare and Devastating Complication of Penetrating Keratoplasty: Postoperative Endophthalmitis Because of Carbapenem-Resistant Klebsiella pneumoniae.
Kubra Sincar, Oguz Reşat Sipahi, Mervenur Kanat et al.
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Case in brief
A 69-year-old woman developed early-onset endophthalmitis due to carbapenem-resistant Klebsiella pneumoniae following elective penetrating keratoplasty for bullous keratopathy. Within 24 hours post-surgery, she exhibited stromal infiltration and anterior chamber reaction, leading to urgent rekeratoplasty. Despite aggressive antimicrobial treatment, the infection progressed to orbital cellulitis and systemic involvement, necessitating evisceration.
What made this case unusual
This case represents the second documented occurrence of endophthalmitis caused by carbapenem-resistant Klebsiella pneumoniae after penetrating keratoplasty, highlighting a significant postoperative risk.
Diagnostic / clinical pearl
Clinicians should be aware of the potential for severe infections, such as endophthalmitis from carbapenem-resistant organisms, following penetrating keratoplasty, emphasizing the need for vigilant donor screening.
Why it matters
This case underscores the critical importance of monitoring donor tissue and the storage environment to prevent contamination and severe postoperative complications.