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Published on: August 6, 2021
Saved by My Specs: Incidental central retinal vein occlusion uncovering infective endocarditis - A case report
Daniel Broderick1, Ciara Murray1, Padraig McGettrick1
1Department of Infectious Diseases, Mater Misericordiae University Hospital, Eccles Street, Phibsboro, Dublin 7, D07R2WY, Ireland.
Abstract:
We describe a case of a 74-year-old man with a history of bioprosthetic aortic valve replacement who was diagnosed with Granulicatella adiacens (G. adiacens) infective endocarditis (IE) following an incidental finding of central retinal vein occlusion (CRVO) during a routine optician visit. Despite minimal symptoms on presentation, blood cultures grew G. adiacens, and imaging revealed a 1 × 1.2 cm aortic valve vegetation plus splenic and cerebral embolic complications. Management was complicated by drug-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, microangiopathic thrombocytopenia, anaemia, and possible subacute glomerulonephritis, leading to deferral of surgery until haematological parameters improved. Following a 9-week antibiotic course and stabilisation of platelet counts, he underwent a successful redo aortic valve replacement, highlighting the indolent yet clinically significant nature of G. adiacens IE and the importance of thorough, multidisciplinary care in complex prosthetic valve infections.
Insights
A rare case of Granulicatella adiacens infective endocarditis (IE) in a patient with a prosthetic aortic valve was diagnosed after a retinal vein occlusion. This indolent infection required complex management and a successful redo valve replacement.
Area of Science:
- Cardiology
- Infectious Diseases
- Hematology
Background:
- Prosthetic valve endocarditis (PVE) poses significant challenges in diagnosis and management.
- Granulicatella adiacens (G. adiacens) is an uncommon but potentially serious cause of infective endocarditis (IE).
- Central retinal vein occlusion (CRVO) can be an incidental finding and a potential indicator of underlying embolic events.
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