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Published on: February 6, 2021
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HISTOPLASMA CAPSULATUM PACEMAKER-RELATED ENDOCARDITIS PRESENTING AS ENDOGENOUS ENDOPHTHALMITIS
Cindy Chen1, Jose A Morillas2, Susan J Rehm2
1Cleveland Clinic Cole Eye Institute, Cleveland, Ohio.
Retinal Cases & Brief Reports
|February 2, 2023
Summary
This case report details a rare instance of pacemaker-related infective endocarditis caused by Histoplasma capsulatum, leading to endogenous endophthalmitis. Early consideration of fungal causes is crucial for patients with endovascular infections.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Cardiology
Background:
- Pacemaker-related infective endocarditis is a serious complication.
- Endogenous endophthalmitis requires prompt diagnosis and treatment.
- Histoplasma capsulatum is an endemic fungus that can cause systemic infections.
Observation:
- A 75-year-old male presented with vision loss and ocular inflammation.
- Blood and vitreous cultures were negative for bacteria, but fungal DNA (Histoplasma capsulatum) was detected in vitreous fluid.
- Histopathology and PCR of the pacemaker lead confirmed Histoplasma capsulatum.
Findings:
- The patient had pacemaker-related infective endocarditis manifesting as endogenous endophthalmitis.
- Histoplasma capsulatum was identified as the causative agent.
- Despite treatment, the ocular condition progressed to phthisis.
Implications:
- Histoplasma capsulatum should be considered in the differential diagnosis of endogenous endophthalmitis, especially in endemic areas.
- This case highlights the importance of a multidisciplinary approach in managing complex infections.
- Early identification and treatment of fungal endocarditis can potentially improve patient outcomes.
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