SHM Converge Scientific Abstract ePoster Gallery-Endogenous Endophthalmitis Unveiled: A Blinding Complication of Hypervirulent Klebsiella Pneumonia in a Hospitalized Patient

Endogenous Endophthalmitis Unveiled: A Blinding Complication of Hypervirulent Klebsiella Pneumonia in a Hospitalized Patient

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This case describes a 71-year-old man with poorly controlled type 2 diabetes, chronic kidney disease, and hypertension who developed sudden painful vision loss in his right eye. His symptoms were preceded by headaches, vertigo, and intermittent hearing loss over two weeks. After worsening floaters and complete vision loss, ophthalmology suspected endophthalmitis. On admission, he was febrile, encephalopathic, and hypoxemic with acute kidney injury.<br /><br />A vitreous tap and cultures confirmed hypervirulent Klebsiella pneumoniae (HvKP) endogenous endophthalmitis. Blood cultures also grew K. pneumoniae, and abdominal imaging revealed a new hepatic lesion consistent with a liver abscess. The abscess was drained by interventional radiology and cultured the same organism, supporting a disseminated HvKP infection.<br /><br />Despite treatment with systemic ceftriaxone and repeated intravitreal antibiotics, the patient’s eye pain persisted and vision did not recover. Ultimately, ophthalmology recommended evisceration with tarsorrhaphy of the affected eye.<br /><br />This case highlights endogenous endophthalmitis as a rare but devastating metastatic complication of HvKP liver abscess, particularly in patients with diabetes. HvKP is associated with hypermucoviscosity, K1/K2 capsular serotypes, and increased virulence factors, and it can cause invasive disease with ocular spread. The report emphasizes the need for early recognition, high clinical suspicion, and multidisciplinary care involving medicine, ophthalmology, infectious diseases, and interventional radiology. Delayed diagnosis can lead to irreversible vision loss or loss of the eye.

Asset Subtitle

Reid Woods

Meta Tag

Author List Reid Woods

Category Clinical Vignettes

Concept Endogenous Endophthalmitis

Concept Hypervirulent Klebsiella pneumoniae

Concept Pyogenic Hepatic Abscess

Concept Intravitreal Antibiotics

Concept Diabetes Mellitus

Distinguished Non-Finalist

Presenter Organization NYU Langone Health

Presenting Author Reid Woods

Track Adult

Keywords

hypervirulent Klebsiella pneumoniae

endogenous endophthalmitis

liver abscess

diabetes mellitus

vision loss

vitreous culture

bacteremia

metastatic infection

intravitreal antibiotics

evisceration

Endogenous Endophthalmitis

Hypervirulent Klebsiella pneumoniae

Pyogenic Hepatic Abscess

Intravitreal Antibiotics

Diabetes Mellitus