Klebsiella pneumoniae Endogenous Endophthalmitis in an Active Duty Service Member.
Marc-Eli M Faldas, Jonathan M Letko, Ariel L Hoffman
✦ AI-curated · Sources linked
Case in brief
A healthy, immunocompetent 47-year-old active-duty man developed fever, chills, and fatigue, tested positive for COVID, and then experienced painful right-eye vision loss with a temporal field deficit. Orbital MRI showed endophthalmitis. Blood cultures grew Klebsiella pneumoniae; elevated liver-associated enzymes led to abdominal CT, which showed complex hepatic lesions, and biopsy cultures also grew K. pneumoniae. The authors speculated that the liver abscesses seeded the bloodstream and then the eye. The report describes endogenous endophthalmitis associated with K. pneumoniae liver abscesses in a patient without known risk factors.
What made this case unusual
The patient was immunocompetent and had no known risk factors, despite developing K. pneumoniae endogenous endophthalmitis with hepatic abscesses. His deployments to Asia raised the possibility of exposure to a hypervirulent strain, but this was not established.
Diagnostic / clinical pearl
In a patient with endophthalmitis and K. pneumoniae bacteremia, assess for a hepatic source; in this case, liver imaging and abscess biopsy identified matching K. pneumoniae.