Report of Four Cases of Endogenous Klebsiella Pneumoniae Endophthalmitis Originated from Liver Abscess with Eye Complaints as the Initial Presentations

Purpose To report four cases of endogenous endophthalmitis (EE) secondary to Klebsiella pneumoniae liver abscess, and discuss their clinic features and outcomes.Methods Clinical data were collected by reviewing the medical records of four patients diagnosed with endogenous Klebsiella Pneumoniae endophthalmitis (EKPE) secondary to liver abscess.Results Four patients were diagnosed with EE. Two males and two females, with ages ranging from 33 to 63 years old. All patients presented with ocular symptoms initially. Liver abscesses were diagnosed during hospitalization. All cases were caused by Klebsiella Pneumoniae confirmed by blood or tissue cultures. All patients were treated with intravitreal antibiotic injection, and two of the patients had vitrectomy. At the end, all affected eyes underwent evisceration. One patient died of septic shock with multiple organ failures.Conclusion EE secondary to liver abscess with metastatic spread is a severe sight-threatening condition. The delayed discovery of liver abscess may hinder the diagnosis and treatment of the disease, which may be related to poor prognosis.