Bilateral foveal cysts secondary to Streptococcus constellatus endocarditis

详细信息    查看全文

• 作者：Anish N. Shah (1)
  Benoy N. Shah (3)
  Sarah Glover (2)
  Luke Herbert (1)
  
• 关键词：Endocarditis ; Subacute bacterial ; Retinal hemorrhage ; Tomography ; Optical coherence
• 刊名：International Ophthalmology
• 出版年：2013
• 出版时间：June 2013
• 年：2013
• 卷：33
• 期：3
• 页码：315-317
• 全文大小：322KB
• 参考文献：1. Burton M, Gregor Z (2007) Retinal Arterial Occlusion. In: Joussen AM et al (eds) Retinal vascular disease. Springer, Berlin, p 508
  2. Levin RM, Pulliam L, Mondry C, Levy D, Hadley WK, Grossman M (1982) Penicillin-resistant / Streptococcus constellatus as a cause of endocarditis. Am J Dis Child 136(1):42-5
  3. Ejima K, Ishizuka N, Tanaka H, Tanimoto K, Shoda M, Kasanuki H (2003) Prosthetic valve endocarditis caused by / Streptococcus constellatus infection complicated with perivalvular abscess: serial observation by transesophageal echocardiography: a case report. J Cardiol 42(3):129-33
  4. Chheda LV, Sobol WM, Buerk BM, Kurz PA (2011) Endogenous endophthalmitis with brain abscesses caused by / Streptococcus constellatus. Arch Ophthalmol 129(4):517-18. doi:10.1001/archophthalmol.2011.59 CrossRef
  5. Beatty S, Harrison RJ, Roche P (1997) Bilateral macular holes resulting from septic embolization. Am J Ophthalmol 123(4):557-59
  6. Ling R, James B (1998) White-centred retinal haemorrhages (Roth spots). Postgrad Med J 74(876):581-82 CrossRef
  
• 作者单位：Anish N. Shah (1)
  Benoy N. Shah (3)
  Sarah Glover (2)
  Luke Herbert (1)
  
  1. Eye Clinic, East Surrey Hospital, Canada Avenue, Redhill, RH1 5RH, UK
  3. Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
  2. Department of Microbiology, East Surrey Hospital, Canada Avenue, Redhill, RH1 5RH, UK
  
• ISSN：1573-2630

文摘

Infective endocarditis can be acute or subacute, depending on the virulence of the causative organism. It can also cause loss of vision by a variety of mechanisms, ranging from embolic retinal artery occlusion to endogenous endophthalmitis. We illustrate the first report of foveal cyst formation secondary to infective endocarditis. A 53-year-old man presented to his general practitioner with a variety of constitutional symptoms, but initial laboratory and imaging investigations revealed only mild normocytic anaemia, and he was discharged from further medical care. Four weeks later he developed bilateral visual loss associated with whitish lesions of the superficial retina at both foveae. These later developed into foveal cysts with disruption of the photoreceptor inner segment–outer segment junction and persistent poor visual acuity of 6/60 OU. No retinal haemorrhages or Roth spots were noted. Only after he presented with visual loss did further investigations reveal the underlying diagnosis of streptococcal endocarditis. Ophthalmologists assessing retinal pathology which presents in association with undiagnosed constitutional symptoms are advised to refer such patients promptly for thorough medical investigation, including blood culture and echocardiography where appropriate.