DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.065

Pages: 2465-2469

Endogenous endophthalmitis (EE) is an uncommon but vision-threatening intraocular infection resulting from hematogenous spread of microorganisms from a distant systemic focus. It typically affects immunocompromised or diabetic patients and requires prompt recognition and treatment to prevent irreversible visual loss. A 47-year-old man with poorly controlled type 2 diabetes mellitus presented with diabetic ketoacidosis secondary to a pyogenic liver abscess. During hospitalization, he developed sudden, painless vision loss in the left eye. Ophthalmic examination revealed findings consistent with EE. Despite negative microbiological cultures, empirical treatment with intravitreal vancomycin and ceftazidime, in conjunction with fortified topical and systemic antibiotics, was promptly initiated. Percutaneous drainage of the liver abscess was also performed. Rapid initiation of combined ophthalmic and systemic therapy resulted in marked clinical improvement, with near-complete visual recovery one month after treatment. This case underscores the importance of early recognition and multidisciplinary management of EE in high-risk patients. Prompt intravitreal antibiotic administration and effective control of the primary infection source are critical to preserving visual function and improving prognosis.