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Favorable Outcome in Recalcitrant Klebsiella pneumoniae Endogenous Endophthalmitis: A Case Report - Cureus

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Endogenous endophthalmitis is an aggressive intraocular infection with a characteristically poor visual prognosis. We present a 55-year-old Malay woman with suboptimally controlled diabetes mellitus who developed sepsis from a liver abscess. Following the isolation of Klebsiella pneumoniae from the abscess drainage, which demonstrated susceptibility to gentamicin and trimethoprim-sulfamethoxazole, she was commenced on targeted systemic antimicrobial therapy. During her admission, she reported a sudden visual decline in her left eye, with visual acuity decreasing to 6/21. Clinical examination of the left eye revealed anterior chamber inflammation with a hypopyon, alongside pronounced vitritis and retinitis, while the right eye remained entirely unaffected. Recognizing this as Klebsiella pneumoniae endogenous endophthalmitis, we immediately performed a vitreous tap and injected intravitreal vancomycin and ceftazidime, proceeding to a trans pars plana vitrectomy (TPPV) with repeat intravitreal antibiotics the following day. Although her vitreous fluid cultures returned negative, the infection resolved on a postoperative regimen of topical 0.5% moxifloxacin, systemic ciprofloxacin, and

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