Klebsiella metastatic endophthalmitis - a complication of shock wave lithotripsy

A 70-year-old man suffering from nephrolithiasis developed acute pyelonephritis following extracorporeal shock wave lithotripsy of renal stones. After 10 days, urosepsis complicated by meningitis was diagnosed, and 72 hours later he developed right panophthalmitis with perforation of the globe, which was treated by enucleation. A week later, while on cefotaxime and cefuroxime, a focal infectious process developed in the retina of the left eye's posterior pole, spreading into the vitreous and causing retinal detachment. The patient was treated by vitrectomy and retinal detachment surgery, with good anatomical results. The functional result, however, was poor. Endophthalmitis is a possible complication, though rare, of urosepsis in patients undergoing shock wave lithotripsy.