Premacular hemorrhage as a sign of subacute bacterial endocarditis

We examined a patient with mitral valve insufficiency, a sudden decrease in vision in the right eye, and premacular hemorrhage, which was a sign of subacute bacterial endocarditis.

The patient was hospitalized and treated with intravenous antibiotics. Blood cultures grew Streptococcus viridans. Ocular symptoms and signs improved over two months. Premacular hemorrhage may be a sign of subacute bacterial endocarditis and may obscure other classic signs. Subacute bacterial endocarditis should be included in the differential diagnosis of premacular hemorrhage.