title: Endogenous endophthalmitis with a visual acuity of 6/6.
abstract: A 43-year-old man suffering from Klebsiella liver abscess and bacteraemia presented with left eye visual disturbance a few days after admission. His visual acuity was 6/6. There was a whitish subretinal mass located at the temporal periphery without vitritis. His visual acuity dropped to 6/120 with marked vitritis 1 day later and a diagnosis of a subretinal abscess was made. The vitreous cultures were negative. Response was suboptimal with intravitreal antibiotics, and retinotomy, vitrectomy, antibiotic irrigation and silicone oil tamponade were required. His vision gradually improved to 6/60 with silicone oil in situ. This case illustrates the rare presentation of a subretinal abscess in endogenous endophthalmitis with no initial associated vitritis, and the importance of maintaining a high level of suspicion despite good visual acuity on presentation in cases with relevant history. Early detection and intervention, and close monitoring may salvage the patient's vision in such cases.
authors: The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Gillian Denise Ji-Yee
authors: GD
authors: Siu
authors: The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Ernie Chi-Fung
authors: EC
authors: Lo
authors: The Chinese University of Hong Kong, Shatin, Hong Kong.
authors: Alvin
authors: http://orcid.org/0000-0002-4365-3218
authors: A
authors: Young
mesh_terms: D000038:Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008100:Liver Abscess / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D012164:Retinal Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D000900:Anti-Bacterial Agents