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Bilateral endogenous endophthalmitis associated with infective endocarditis: case report
E S Arcieri1, E F Jorge, L de Abrea Ferreira
1School of Medicine, Federal University of Uberlândia, MG, Brazil. rsaran@triang.com.br
Summary
Bilateral endogenous endophthalmitis, a rare bloodstream infection, can cause sudden vision loss, particularly in patients with prosthetic heart valves. Early diagnosis and treatment are crucial but may not prevent fatal outcomes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Cardiology
Background:
- Bilateral endogenous endophthalmitis is a rare but severe ocular infection originating from microbial seeding through the bloodstream.
- Infective endocarditis is a significant risk factor, especially in patients with prosthetic heart valves.
Observation:
- A 49-year-old male with a recent metallic aortic valve replacement presented with sepsis symptoms including fever, cough, dyspnea, diarrhea, and confusion.
- Sudden, profound bilateral vision loss occurred during hospitalization, indicating rapid ocular involvement.
Findings:
- Blood cultures identified a Gram-positive coccobacillus, confirming bacteremia.
- Prompt treatment with fluoroquinolones led to fever resolution, reduced ocular inflammation, and partial visual recovery (light perception).
Implications:
- This case highlights the critical importance of recognizing ocular manifestations in patients with endocarditis and prosthetic valves.
- Despite aggressive management, the patient's outcome was poor, underscoring the challenges in treating severe endogenous endophthalmitis.
- Ocular symptoms can be an early indicator of systemic infection, necessitating rapid diagnostic and therapeutic interventions.