Enterococcus faecalis Endogenous Endophthalmitis from Valvular Endocarditis

Area of Science:

• Ophthalmology
• Cardiology
• Infectious Diseases

Background:

• Endogenous endophthalmitis is a severe intraocular infection.
• Prosthetic cardiac valves are a potential source of endogenous endophthalmitis.
• Enterococcus faecalis endocarditis can lead to systemic complications.

Purpose of the Study:

• To report a case of endogenous endophthalmitis secondary to prosthetic mitral valve endocarditis.
• To highlight the importance of considering cardiac sources in endogenous endophthalmitis.
• To emphasize the multidisciplinary approach in managing such cases.

Main Methods:

• Case report of a 74-year-old female with a prosthetic mitral valve.
• Clinical presentation included unilateral vision loss, corneal edema, and hypopyon.
• Diagnosis of Enterococcus faecalis mitral endocarditis was confirmed.
• Systemic and ocular findings were monitored during treatment.

Main Results:

• The patient developed endogenous endophthalmitis with severe vision loss (light perception only) in the affected eye.
• Systemic treatment with gentamicin, vancomycin, and linezolid led to clinical improvement of endocarditis.
• Ocular complications included total cataract and posterior synechia, with controlled intraocular pressure.
• Despite treatment, visual acuity in the affected eye did not recover.

Conclusions:

• Cardiac source endophthalmitis should be suspected in patients with prosthetic valves presenting with ocular symptoms.
• Multidisciplinary management involving ophthalmologists and cardiologists is crucial.
• Early diagnosis and treatment are essential, although visual outcomes can be poor.