Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary to<i>Streptococcus agalactiae</i>in a Healthy Adult: Case Report and Literature Review

Sim, Yu Ra; Lee, Ye-Jin; Park, Seung Woon; Kim, Sang Hyun; Choi, Jun Ho; Choi, Jung Yoon; Ahn, Jaemoon; Yoon, Young Kyung

doi:10.3947/ic.2017.49.4.286

Cited by 14 publications

(7 citation statements)

References 19 publications

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“…There have been numerous reports of endocarditis causing endophthalmitis in healthy adults after ICD placement. 5,6 Because our patient was asymptomatic, had a normal transesophageal echocardiogram with no evidence of endocarditis, and had negative blood and ocular cultures for bacterial and fungal organisms, we were able to rule out EE and diagnose toxoplasmosis, a common cause of unilateral posterior uveitis.…”

Section: Discussionmentioning

confidence: 98%

Toxoplasmosis Retinochoroiditis Masquerading as Endogenous Endophthalmitis in a Case of Congenital Long Qt Syndrome

Adam¹,

Abrams²

2022

RETINAL Cases &Amp; Brief Reports

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Purpose: To describe the diagnostic and treatment challenges of a case of presumed acquired macula-involving toxoplasmosis retinochoroiditis.Methods: Case report of a woman with congenital long QT syndrome presenting with retinochoroiditis after undergoing a cardiac procedure. Laboratory analysis, ocular fluid biopsy, and multimodal imaging were obtained.Results: Ophthalmic examination was significant for decreased vision and a maculainvolving chorioretinal lesion concerning for endogenous endophthalmitis. Multimodal imaging showed a focal, full-thickness necrotizing process associated with vitritis, retinal edema, and choroidal thickening. Analysis of peripheral blood revealed elevated serum toxoplasma Immunoglobulin G titers. Blood cultures and a transesophageal echocardiogram were negative for endocarditis. Aqueous and vitreous specimens were negative for an infectious polymerase chain reaction panel, including toxoplasmosis and negative bacterial and fungal cultures. A diagnosis of presumed acquired toxoplasmosis retinochoroiditis was made and treated with a combination of oral and intravitreal antiparasitic medications resulting in healing of the retinochoroiditis. Conclusion:To the authors' knowledge, this is the first reported case of acquired toxoplasmosis retinochoroiditis in an immunocompetent patient with congenital long QT syndrome masquerading as endogenous endophthalmitis. The association of congenital long QT syndrome and a recent cardiac procedure with a risk for endogenous endophthalmitis complicated the diagnosis, clinical course, and treatment options. Our case emphasizes the importance of a thorough patient history, comprehensive clinical examination, and supportive multimodal imaging that were used to characterize the infectious process and guide empirical treatment. In addition, laboratory analysis, comanagement with other specialists, and evaluating the response to antitoxoplasma therapy were all instrumental in the eventual diagnosis and treatment of ocular toxoplasmosis in this atypical case.

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Section: Discussionmentioning

confidence: 98%

Toxoplasmosis Retinochoroiditis Masquerading as Endogenous Endophthalmitis in a Case of Congenital Long Qt Syndrome

Adam¹,

Abrams²

2022

RETINAL Cases &Amp; Brief Reports

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“…In their review, Sim et al reported that the prevalence of endogenous bacterial endophthalmitis was 5-7% of all causes of endophthalmitis (6). Schiedler et al reported that the prevalence of mortality in endogenous bacterial endophthalmitis was 29%, which was significantly higher than that of other types of endophthalmitis (11).…”

Section: Discussionmentioning

confidence: 99%

The Early Diagnosis of Endophthalmitis Due to Group B Streptococcus Infective Endocarditis and Its Clinical Course: A Case Report and Literature Review

et al. 2019

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A 68-year-old Japanese man was admitted to our hospital with right eye pain, a sudden worsening of his eyesight, and a fever. He was diagnosed with endogenous bacterial endophthalmitis due to infectious endocarditis (IE) of Group B Streptococcus (GBS) on the day of admission. He recovered systemically, but his right eye became phthisical only with the administration of antibiotics. We conducted a review of the reported cases of IE caused by GBS complicated with endogenous bacterial endophthalmitis. IE should be considered when an undetermined etiology of endogenous endophthalmitis is encountered. The prompt diagnosis and treatment of IE will improve patients' outcomes.

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“…Cellulitis and skin abscesses are caused by bacteria, and the most common etiological factors are Group A beta-hemolytic Streptococcus and Staphylococcus aureus [ 52 ]. There are also reports in the literature about EE caused by group B streptococcus, where soft tissue inflammation is the most common source of infection, next to the aforementioned endocarditis [ 53 ]. As in other sources of infection, the factors predisposing the development of EE in the course of infection of soft tissues are diabetes, intravenous drug use, and immunodeficiency [ 54 ].…”

Section: Primary Source Of Infectionmentioning

confidence: 99%

Endogenous Endophthalmitis—The Clinical Significance of the Primary Source of Infection

Gajdzis

Figuła

Kamińska

et al. 2022

JCM

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Endophthalmitis is a severe form of ocular inflammation. The source of pathogens in endogenous endophthalmitis is located inside the body, and infection spreads hematogenously. Although rare, endogenous endophthalmitis is a very serious condition, as this type of inflammation is very devastating for ocular tissues. Prognosis is very poor, and the patients are often in a serious general condition, so they require special care and an individual approach in the treatment process. Thanks to the knowledge of the risks associated with infections of individual tissues and organs as well as potential pathogens and the clinical picture, it is possible to make a correct diagnosis faster and implement the correct treatment. In the case of endogenous endophthalmitis, reaction time is absolutely crucial for prognosis. In this review, we focus primarily on the importance of the primary source of infection for the course of the disease and prognosis.

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Infective Endocarditis Presenting as Endogenous Endophthalmitis Secondary toStreptococcus agalactiaein a Healthy Adult: Case Report and Literature Review

Cited by 14 publications

References 19 publications

Toxoplasmosis Retinochoroiditis Masquerading as Endogenous Endophthalmitis in a Case of Congenital Long Qt Syndrome

Toxoplasmosis Retinochoroiditis Masquerading as Endogenous Endophthalmitis in a Case of Congenital Long Qt Syndrome

The Early Diagnosis of Endophthalmitis Due to Group B Streptococcus Infective Endocarditis and Its Clinical Course: A Case Report and Literature Review

Endogenous Endophthalmitis—The Clinical Significance of the Primary Source of Infection

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