Septic metastatic endophthalmitis complicating Klebsiella pneumoniae liver abscess in a non-diabetic Chinese man

TY Wong, SI Chiu, MK So, MK Tsang, JY Lai, ST Lai, KK Tse, IYF Io
Department of Medicine and Geriatrics, Princess Margaret Hospital, Laichikok, Kowloon, Hong Kong

Septic metastatic endophthalmitis is a rare but serious disease. Endophthalmitis arising from Klebsiella pneumoniae liver abscess has been reported with diabetes mellitus as a major associated condition, but is rarely seen in patients without diabetes. A non-diabetic patient with liver abscess complained of right eye discomfort and floaters 3 days after admission. Both blood and liver aspirate cultured Klebsiella pneumoniae . The patient was treated initially with systemic and subconjunctival antibiotics followed by intravitreal antibiotics with successful visual salvation. Previous reports from the literature showed poor visual outcome despite treatment and delayed recognition was often the cause. Clinicians should be alert to endophthalmitis whenever a patient with Klebsiella pneumoniae liver abscess complains of ocular symptoms. Urgent ophthalmological assessment should be sought.

Hong Kong Med J 2001;7:303-6

Key words: Endophthalmitis/diagnosis; Eye/pathology; Klebsiella pneumoniae ; Liver abscess