Bilateral endogenous bacterial endophthalmitis associated with pyogenic hepatic abscess

Editor,—Endogenous or metastatic bacterial endophthalmitis is rare, with a prevalence of approximately 2–8% of all cases of endophthalmitis.1 Endogenous bacterial endophthalmitis is associated with chronic diseases such as diabetes mellitus and renal failure, invasive medical procedures, and non-ocular surgery, injecting drug abuse, or prolonged placements of central venous lines.1 Gram positive bacteria are the most common causative organisms of endogenous bacterial endophthalmitis.1 A small number of cases of endogenous bacterial endophthalmitis due to Klebsiella pneumoniae , a Gram negative organism, have previously been reported, with the majority of the cases originating in Taiwan.2-7 K pneumoniae endophthalmitis is associated with diabetes mellitus and hepatic abscesses, can be bilateral, and is also associated with a poor visual outcome.2-7 We report the case of a Taiwanese seaman who developed bilateral endogenous bacterial endophthalmitis after presenting with a pyogenic hepatic abscess. ### CASE REPORT A 40 year old male surgical inpatient was reviewed after he complained of a 3 day history of bilateral painful red eyes and reduced visual acuity. The patient, a previously healthy Taiwanese seaman airlifted from a ship 1 week earlier, had a right hepatic lobe abscess measuring 3.6 cm × 7.5 cm. This had …