Abstract
BackgroundOcular manifestations of infective endocarditis are nonspecific and rare. Endophthalmitis, retinal artery occlusion, Roth spots and vitreal and retinal infiltrations can all be seen with infective endocarditis. Also, infective endocarditis involving the left atrial appendage with no involvement of the mitral valve apparatus is a rarity.Case presentationHere we report a case of infective endocarditis of the heart involving the left atrial appendage presenting with features of endogenous endophthalmitis which ultimately progressed to phthisis bulbi with subtle cardiac symptoms in a previous healthy young adult.ConclusionInfective endocarditis involving the left chambers of the heart carries an inherent high risk of systemic embolization. Panophthalmitis which is considered to be the most severe form of endogenous endophthalmitis is a rare presenting feature. Although a definitive treatment algorithm is lacking, early surgery and parenteral antibiotics along with local antibiotic injections could help to save the vision.
Highlights
Ocular manifestations of infective endocarditis are nonspecific and rare
Infective endocarditis involving the left chambers of the heart carries an inherent high risk of systemic embolization
Endogenous bacterial endophthalmitis (EBE) is an uncommon intraocular infection caused by hematogenous spread of microorganisms to the eye from extraocular sites, such as the heart, urinary tract or cerebral meninges
Summary
Infective endocarditis involving the left chambers of the heart carries an inherent high risk of systemic embolization. Panophthalmitis which is considered to be the most severe form of endogenous endophthalmitis is a rare presenting feature. A definitive treatment algorithm is lacking, early surgery and parenteral antibiotics along with local antibiotic injections could help to save the vision
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