Unrelenting Vision Loss: The Virulence of Klebsiella pneumoniae

Abstract

A 37-year-old Hispanic male with a recent history of COVID-19 infection and type 2 diabetes mellitus was admitted to the hospital with shortness of breath, chest pain, and hyperglycemia. Eye exam and imaging findings indicated endogenous endophthalmitis confirmed by blood cultures that speciated to Klebsiella pneuomoniae. The patient's eye condition progressed, ultimately resulting in no light perception less than a month after the initial evaluation. Due to the rapidly progressive nature of Klebsiella endogenous endophthalmitis, we recommend that primary teams consult ophthalmology for close monitoring of patients with a high index of suspicion.

Keywords: endophthalmitis; intravitreal antibiotic; klebsiella endophthalmitis; klebsiella pneumoniae; subretinal abscess.

Figure 1. Initial B-scan (hospital day four) with vitreous debris and temporal subretinal abscess formation

Figure 2. B-scan (hospital day 11) with worsening subretinal abscess growth, loculations, and vitritis

Figure 3. B-scan (hospital day 23) with diffuse, near-total shallow retinal detachment

Figure 4. B-scan (hospital day 23) demonstrating the area of retinal attachment at the optic nerve; diffuse vitreous debris with loculated collections are present