From Gut to Globe: Endogenous Endophthalmitis as a Sentinel Sign of Polymicrobial Intra-Abdominal Infection.

A 42-year-old male presented with 1 week of left eye redness, pain, and severe vision loss. Examination revealed anterior chamber fibrin, vitritis, and vitreous opacities. B-scan ultrasonography showed mobile hyperechoic vitreous material with an attached retina. Given his recurring fevers, a vitreous tap and injection of intravitreal antibiotics was performed, followed by systemic infectious workup. Blood cultures revealed polymicrobial bacteremia with Klebsiella pneumoniae and Salmonella serogroup B, secondary to colonic and hepatic abscesses confirmed by CT. Despite treatment, the eye progressed to phthisis bulbi. This case underscores the importance of ocular symptoms in identifying serious systemic infections.