Hypermucoviscous Klebsiella corneal abscess: Infection from inside out
Bibliographic record
Abstract
BackgroundCorneal ulcers are typically caused by external ("exogenous") factors such as trauma, contact lens use, or preexisting ocular surface diseases. Internal systemic ("endogenous") sources have not been reported as direct causes of corneal ulcers. Here, we report, to our knowledge, the first documented case of a corneoscleral abscess that resulted from an underlying bacteremia.MethodThis is a single case report.ResultA previously healthy 35-year-old male presented to the Emergency Department with left eye redness, pain, and blurred vision. Initial examination showed reduced visual acuity (20/150), elevated intraocular pressure (44mmHg), diffuse microcystic corneal edema with mutton-fat keratic precipitates, and anterior chamber cells. No corneal infiltrate, epithelial defect, hypopyon, or vitritis was noted. Within days, his condition rapidly progressed to a corneoscleral abscess with auto-evisceration. Blood and corneal cultures identified hypermucoviscous Klebsiella pneumoniae. Further workup revealed an underlying prostatic abscess with secondary iliac vein thrombus, leading to seeding of other sites, including the lungs and the eye. Despite intensive antibiotic therapy, the ocular condition worsened, requiring urgent left eye evisceration.ConclusionThis case highlights the rapid progression of hypermucoviscous Klebsiella pneumoniae infection, which first presented with endophthalmitis, followed by corneoscleral perforation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".