{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T07:00:40Z","timestamp":1772953240166,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,11,1]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>A 48-year-old man presented with a non-healing wound on his left foot after stepping on a nail. He self-medicated with amoxicillin, but the wound progressed prompting consult. On examination, his left foot was diffusely swollen with surrounding erythema, areas of gangrene, foul-smelling purulent discharge and subcutaneous emphysema. He was managed as a case of necrotising fasciitis and underwent emergent amputation. Three days after amputation, he developed a sudden and progressive blurring of vision, swelling and conjunctival erythema, with purulent discharge and the presence of hypopyon on the left eye. He was then managed as a case of endophthalmitis of the left eye and underwent pars plana vitrectomy. All cultures (blood, tissue and vitreous fluid) grew pan-susceptible hypermucoviscous <jats:italic>Klebsiella pneumoniae<\/jats:italic>, with positive string tests and confirmed by multilocus gene sequencing and sequence type analysis. He gradually improved with intravenous antibiotics, but only regained light perception in the left eye.<\/jats:p>","DOI":"10.1136\/bcr-2018-226096","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e226096","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Hypermucoviscous capsular 1 (K1) serotype <i>Klebsiella pneumoniae<\/i> necrotising fasciitis and metastatic endophthalmitis"],"prefix":"10.1136","volume":"11","author":[{"given":"Harold Henrison Chang","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian Nadonga","family":"Francisco","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Racquel","family":"Bruno","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Jorge II","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edsel Maurice","family":"Salva\u00f1a","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, College of Medicine & Philippine General Hospital, University of the Philippines Manila, Manila, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"2025082703391450000_11.1.e226096.1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.043638-0"},{"key":"2025082703391450000_11.1.e226096.2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2014.11.23599"},{"key":"2025082703391450000_11.1.e226096.3","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-004-1125-5"},{"key":"2025082703391450000_11.1.e226096.4","first-page":"1171","article-title":"Klebsiella pneumoniae necrotizing fasciitis of the leg in an elderly French woman","volume":"18","author":"Monie","year":"2014","journal-title":"Clin Interv Aging"},{"key":"2025082703391450000_11.1.e226096.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-014-0722-x"},{"key":"2025082703391450000_11.1.e226096.6","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1080\/09273948.2016.1193616","article-title":"Klebsiella pneumoniae infection leads to a poor visual outcome in endogenous endophthalmitis: a 12-year experience in southern Taiwan","volume":"25","author":"Chen","year":"2017","journal-title":"Ocul Immunol Inflamm"},{"key":"2025082703391450000_11.1.e226096.7","first-page":"1","article-title":"Klebsiella pneumoniae liver abscess and metastatic endophthalmitis","volume":"4","author":"Wells","year":"2015","journal-title":"J Investig Med High Impact Case Rep"},{"key":"2025082703391450000_11.1.e226096.8","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-016-0274-y"},{"key":"2025082703391450000_11.1.e226096.9","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1330-0"},{"key":"2025082703391450000_11.1.e226096.10","doi-asserted-by":"publisher","DOI":"10.4161\/viru.22718"},{"key":"2025082703391450000_11.1.e226096.11","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4178-4182.2005"},{"key":"2025082703391450000_11.1.e226096.12","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msw054"},{"key":"2025082703391450000_11.1.e226096.13","doi-asserted-by":"crossref","unstructured":"Argim\u00f3n S , Abudahab K , Goater RJ , et al . Microreact: visualizing and sharing data for genomic epidemiology and phylogeography. Microb Genom 2016;2.doi:10.1099\/mgen.0.000093","DOI":"10.1099\/mgen.0.000093"},{"key":"2025082703391450000_11.1.e226096.14","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00676-11"},{"key":"2025082703391450000_11.1.e226096.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2012.02.007"},{"key":"2025082703391450000_11.1.e226096.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.09.025"},{"key":"2025082703391450000_11.1.e226096.17","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12664"},{"key":"2025082703391450000_11.1.e226096.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2012.03953.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bcr-2018-226096","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:39:23Z","timestamp":1756291163000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,11,28]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/bcr-2018-226096"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226096","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}