Bilateral Endogenous Endophthalmitis in an Asian Female

Aims: To report a case of bilateral endogenous endophthalmitis in an elderly Asian female.
Presentation of Case: An elderly Filipino female complaining of sudden blurring of vision of the right eye sought consult at our institution. Ophthalmologic examination, and vitreous tap were done for both eyes and systemic work-up was facilitated to localize the source of infection. Vitreous sample of the right eye yielded positive for Klebsiella pneumoniae, but cultures were sterile on the left. Systemic work-up revealed a complicated nephrolithiasis. Within 24 hours of her admission, vision rapidly deteriorated to no light perception. There was no return in vision despite systemic and topical antibiotic treatment.
Discussion: Endogenous endopthalmitis is a relatively rare condition. Among Asians, the patient at highest risk for endogenous endophthalmitis is a diabetic with Klebsiella hepatobiliary infection. However, this patient was found to have a urinary tract infection.
Conclusion: Klebsiella pneumoniae endopthalmitis confers a poor prognosis necessitating a high index of suspicion and early intervention.