Publish in this journal
Journal Information
Vol. 68. Issue 9.
Pages 804 (September 2015)
Share
Share
Download PDF
More article options
Vol. 68. Issue 9.
Pages 804 (September 2015)
Image in cardiology
DOI: 10.1016/j.rec.2014.10.017
Full text access
Endophthalmitis and a Heart Murmur
Endoftalmitis y soplo
Visits
...
Isabel Zegrí
Corresponding author
isabelzegri@gmail.com

Corresponding author:
, Susana Mingo Santos, Pablo García-Pavía
Departamento de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (1)
Additional material (2)
Full Text

A 48-year-old man, a heavy smoker and drinker, came to the emergency department complaining of pain, redness, and vision loss in his left eye (Figure A). Physical examination revealed a body temperature of 38.7°C and hyperemic left conjunctiva. His oral hygiene was clearly poor and he was missing a number of teeth. Auscultation disclosed the presence of a systolic murmur at the left sternal border, with no signs of heart failure or the peripheral stigmata of endocarditis. Transthoracic and transesophageal echocardiograms showed vegetations anchored on the mitral and tricuspid valves, with moderate mitral and tricuspid regurgitation (Figures B and C and videos 1 and 2 of the supplementary material).

Figure
(0.08MB).

The blood cultures were positive for Streptococcus pneumoniae and antibiotic therapy was initiated with benzyl penicillin. The patient completed his treatment, showing a favorable clinical course. In an echocardiogram performed prior to discharge, the vegetations had disappeared, but mitral and tricuspid regurgitation persisted. He did not recover the vision of his left eye.

Endophthalmitis is an unusual presentation of endocarditis, although this is the most common source of endogenous bacterial endophthalmitis. S pneumoniae is a highly unusual cause of endocarditis (only 1% to 3% of the cases). Alcoholic patients and smokers are especially susceptible to infection by S pneumoniae. It is important to recognize endophthalmitis as a possible initial sign of endocarditis in order to establish the correct diagnosis of this condition and proceed to early initiation of treatment.

Appendix A
Material adicional

Videos 1 and 2. Transthoracic and transesophageal echocardiograms showing vegetations anchored on the mitral and tricuspid valves.

(0.47MB)
(0.52MB)

Copyright © 2014. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.