Abstract
A patient presented with one and a half weeks of blurry vision, redness, and mild discomfort in the left eye, accompanied by fevers and abdominal pain. Examination revealed conjunctival injection and anterior chamber inflammation. Dilated fundus examination demonstrated dense vitritis obscuring the posterior pole, with scattered retinal hemorrhages visible. B-scan ultrasonography revealed a superior dome-shaped subretinal hyperechoic lesion. The patient underwent vitreous tap and intravitreal injection of vancomycin and ceftazidime, along with systemic evaluation for endogenous endophthalmitis. Workup identified a liver abscess, which was managed with interventional radiology-guided drainage. Blood cultures ultimately grew pan-sensitive Klebsiella pneumoniae. Subsequent retinal examination disclosed a subretinal abscess, establishing the diagnosis of endogenous Klebsiella pneumoniae endophthalmitis with a subretinal abscess. The patient was treated with systemic antibiotics and serial intravitreal ceftazidime injections every two to three days, resulting in regression of the abscess and a final visual acuity of 20/25.
Presentation Date: 05/21/2026
Issue Date: 05/22/2026
