Bilateral Endogenous Endophthalmitis With Klebsiella pneumoniae Bacteremia Secondary to Hepatic Abscess

TL;DR

A rare case of eye infection caused by Klebsiella bacteria, linked to a liver abscess, highlights the need for quick treatment to avoid permanent vision loss.

Contribution

This paper presents a rare clinical case of bilateral Klebsiella endophthalmitis with bacteremia and hepatic abscess in the US.

Findings

The patient had Klebsiella pneumoniae bacteremia and a large hepatic abscess.

Bacteremia was cleared with treatment, but vision loss was irreversible.

The case underscores the importance of immediate intervention for Klebsiella endophthalmitis.

Abstract

Klebsiella endophthalmitis is a rare cause of endogenous endophthalmitis, with very few cases documented in the US. We present a male patient in his 60s with a history of latent tuberculosis who presented to the hospital with complaints of acute bilateral vision loss that began three days prior to admission. The workup revealed Klebsiella pneumoniae bacteremia, a large hepatic abscess, severe orbital swelling, and acute angle-closure glaucoma. The patient received intravitreal antibiotics, intravenous antibiotics, a hepatic drain, intraocular pressure-lowering medications, and steroids. Bacteremia was cleared with antibiotics and source control; however, vision loss did not improve. This case emphasizes the acuity and severity of Klebsiella endogenous endophthalmitis and outlines the need for immediate intervention with the onset of symptoms to prevent irreversible vision loss.

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