title: Bilateral endogenous endophthalmitis secondary to endocarditis with negative transesophageal echocardiogram.
abstract: OBJECTIVE
  To present a case of bilateral endogenous endophthalmitis as the primary manifestation of an aortic root abscess and endocarditis, both of which were undetected by transesophageal echocardiogram.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 13-year-old male presented with bilateral endogenous endophthalmitis and previously undiagnosed ventricular septal defect, subaortic stenosis, and a mitral valve cleft.
  
  
  RESULTS
  Cardiac evaluation, systemic evaluation, and transesophageal echocardiogram were negative for endocarditis, but endocarditis and aortic root abscess were discovered at time of cardiac surgery. The patient responded to systemic treatment for endocarditis and surgical management of his cardiac defect.
  
  
  CONCLUSIONS
  A cardiac source for endogenous endophthalmitis should be considered in the presence of clinical diagnosis of bacteremia, despite a negative transesophageal echocardiogram and systemic evaluation.
authors.affiliation: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, 6621 Fannin, Houston, TX 77030, USA. kyen@bcm.tmc.edu
authors.forename: Paul
authors.initials: P
authors.lastname: Park
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Khawly
authors.forename: Debra L
authors.initials: DL
authors.lastname: Kearney
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Altman
authors.forename: Kimberly G
authors.initials: KG
authors.lastname: Yen
mesh_terms: D000038:Abscess / Q000150:complications / Q000000981:diagnostic imaging; D000293:Adolescent; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging; D009877:Endophthalmitis / Q000175:diagnosis / Q000209:etiology*; D006345:Heart Septal Defects, Ventricular / Q000150:complications / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male