First Author: S.Barge PORTUGAL
Co Author(s): R. Rothwell R. Varandas L. Agrelos
Purpose:
To present a case of unilateral endogenous endophthalmitis as the primary manifestation of a prosthetic mitral endocarditis.
Setting:
Department of Ophthalmology , Vila Nova Gaia/Espinho Hospital, Portugal
Methods:
Observational case report.
Results:
We report a case of a 74-year-old female who presented with pain and blurred vision in the right eye for 2 days. Three years before, she had been submitted to mitral valve replacement. Her best corrected visual acuity (BCVA) was light perception in the right eye and 20/40 in the left eye. Slip lamp examination showed corneal edema and hypopyon (1/3 of the anterior chamber) and the fundus was impossible to observe in the right eye. Physical examination of the left eye was unremarkable. Echography showed vitreous condensation. One day after presentation, the patient developed acute lung edema requiring hospitalization, so she was not submitted to intravitreal treatment. The cardiac and systemic evaluations revealed a mitral endocarditis secondary to a enterococus faecalis. The patient improved with treatment with gentamicin, vancomycin and linezulide during 6 weeks. Five weeks later, the patient“s visual acuity was no light perception in the right eye and slip-lamp examination showed hyphema without hypopyion.
Conclusions:
A cardiac source for endogenous endophthalmitis should be considered in the presence of prosthetic mitral valve. The treatment and follow-up must be made in cooperation with a cardiologist specialist, but the ophthalmologist can play a key role in the diagnosis. FINANCIAL DISCLOSURE?: No
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