A Case Report of Endogenous Endophthalmitis Associated With a Pyogenic Liver Abscess Caused by Hypervirulent Klebsiella pneumoniae.

OBJECTIVE: Pyogenic liver abscess (PLA) caused by hypervirulent Klebsiella pneumoniae (hvKp) may be complicated by endogenous endophthalmitis (EE) and pneumonia. We herein report a case of a Chinese male patient with PLA and bilateral EE caused by hvKp to highlight the severe clinical outcomes of this condition. METHODS: This case report describes a 54 year-old male with a history of poorly controlled diabetes mellitus (irregular oral medication and insulin therapy) who presented with a 7-day fever prior to admission. He developed respiratory failure after hospitalization. Klebsiella pneumoniae was identified in sputum, blood, and liver puncture drainage fluid cultures, while vitreous fluid culture was negative. The patient was diagnosed with hvKp-induced PLA complicated by pneumonia and bilateral EE. RESULTS: Despite aggressive systemic and ocular treatment, the patient ultimately lost bilateral visual acuity and developed permanent blindness. Early liver ultrasound confirmed the presence of hvKp-induced PLA. CONCLUSION: Patients with hvKp-induced PLA are at high risk of developing EE, which carries a poor prognosis and may lead to irreversible blindness. Once suspected, prompt systemic and ocular intervention is critical to improve outcomes. This case underscores the value of early liver ultrasound in the diagnosis of hvKp-induced PLA, which may facilitate timely management of life-threatening complications.