From kidney to eye: The devastating consequences of delayed diagnosis

Sepsis workup, including urine cultures, should be routine in renal masses when imaging suggests malignancy. This is to avert vision-threatening consequences in older, immunocompromised patients as seen in this rare case where C. koserii renal abscess was misdiagnosed as a renal cell carcinoma and was complicated by endogenous endophthalmitis (EE), confirmed by urine culture and vitreous PCR. Despite intravitreal antibiotics and pars plana vitrectomy, vision loss was permanent. The renal abscess responded to systemic antibiotics eventually. C. koserii EE is rare and carries poor visual prognosis as shown in previous few cases reported.