Case study of a sudden loss of vision in a diabetic patient: an unusual cause. Endogenous Klebsiella pneumoniae panophthalmitis and cerebellar abscess associated with pyogenic liver abscess

Background: Community-acquired pyogenic liver abscesses due to Klebsiella pneumoniae is increasingly recognized across the world with more incidence in East Asian countries. Cases of endogenous endophthalmitis secondary to pyogenic liver abscesses with K1 serotype K. pneumoniae have been reported in the literature. We report a case of endogenous panophthalmitis along with cerebellar abscess occurring in a newly diagnosed diabetic patient secondary to pyogenic liver abscess. Case presentation: A middle-aged male of east Asian descent presented with sudden onset right eye vision loss associated with fever. Workup revealed newly diagnosed diabetes mellitus, panophthalmitis, cerebellar abscess, and pyogenic liver abscess due to K. pneumoniae. The patient, unfortunately, underwent right eye evisceration. Conclusion: Endogenous panophthalmitis due to K. pneumoniae is a fatal complication and can result in blindness. Multiple foci of infection can be present in such cases. Thorough workup, prompt antibiotics as well as surgical treatment may improve prognosis.