Group B streptococcus endogenous endophthalmitis presenting as septic arthritis and a homonymous hemianopsia due to embolic stroke.
OBJECTIVE
To report a case of group B streptococcus (GBS) endogenous endophthalmitis in a patient presenting with septic arthritis and a homonymous hemianopsia due to embolic stroke.


METHODS
Observational case report.


METHODS
A 75-year-old woman with septic arthritis and a homonymous hemianopsia due to embolic stroke was examined and found to have endogenous GBS endophthalmitis due to bacterial endocarditis.


RESULTS
Magnetic resonance imaging showed many septic emboli to the brain, including the left occipital lobe. Fundus examination showed evidence for endogenous endophthalmitis. Blood and urine cultures were positive for GBS. A mitral valve vegetation was presumed to be the cause of the intracranial septic emboli and was demonstrated on transesophageal echocardiography.


CONCLUSIONS
Septic arthritis and embolic stroke are suggestive of endocarditis and sepsis. Endogenous endophthalmitis in this case led to transesophageal echocardiography, which was diagnostic for endocarditis.
School of Medicine, University of Oklahoma, Oklahoma City, Oklahoma, USA.
Dipesh
D
Pokharel
Andrew P
AP
Doan
Andrew G
AG
Lee
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D009877:Endophthalmitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D015818:Eye Infections, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006423:Hemianopsia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D020766:Intracranial Embolism / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008279:Magnetic Resonance Imaging; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D013292:Streptococcus agalactiae; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014792:Visual Acuity; D058609:Visual Field Tests
D000900:Anti-Bacterial Agents