Atypical ocular and vascular manifestations of Klebsiella liver abscess syndrome.

Klebsiella liver abscess syndrome is an invasive syndrome associated with hypervirulent Klebsiella pneumoniae (hvKp) characterized by pyogenic liver abscesses with potential for metastatic dissemination. This usual colonizer of the gastrointestinal flora has been the culprit of community-onset disease worldwide. We present a unique case of a 33-year-old male with poorly controlled diabetes who developed a liver abscess complicated by hepatic vein thrombophlebitis and exudative retinal detachment without vitritis. Although hypermucoviscosity testing was not performed, this clinical scenario of a community-onset invasive infection with ocular and vascular metastatic dissemination is characteristic of an hvKp strain. This case aims to broaden the recognized radiologic and clinical spectrum of this potentially devastating syndrome and highlights the critical role of imaging in diagnosing its atypical manifestations.