Endogenous Endophthalmitis

A middle-aged patient presented to the ophthalmology emergency department with 1-day of blurred vision in his left eye. He reported fevers the week prior. Examination of the left eye was remarkable for a subretinal abscess with hemorrhage, vasculitis, and a preretinal hypopyon. A vitreous sample was taken, and intravitreal antibiotics were administered in the left eye. He was admitted for a systemic work-up of endogenous endophthalmitis. Blood cultures were positive for Klebsiella pneumoniae. CT scan of the abdomen demonstrated a 7.3×4.5×4.5 cm hypoattenuating lesion with septations in the right lobe of the liver. Klebsiella endophthalmitis is most commonly seen in Asia and has poor visual outcomes when associated with an endogenous source. Diagnosis should prompt abdominal imaging as liver abscesses are associated. The patient was treated with IV antibiotics and the liver abscess was drained by interventional radiology.

Presentation Date: 05/11/2023

Issue Date: 06/02/2023