title: Case of infectious endocarditis predicted by orbital color Doppler imaging.
abstract: BACKGROUND
  There are no specific ocular findings for infectious endocarditis. We report a case of infectious endocarditis detected by combining orbital color Doppler imaging (CDI) and ophthalmological findings.
  
  
  METHODS
  A 47-year-old man suffered from lumbar pain and low-grade fever. He had undergone heart surgery for a ventricular septal defect and received blood transfusions 20 years earlier, and he had started interferon therapy for chronic hepatitis C 8 months previously. Systemic examinations suggested either collagen disease, malignant lymphoma, or infectious disease.
  
  
  METHODS
  The patient underwent a complete ophthalmological examination, including CDI. Ophthalmoscopy showed multiple cotton-wool patches in both eyes and branch retinal artery occlusion in the left eye. Orbital CDI showed that bilateral ophthalmic arteries and central retinal arteries flowed synchronously with abnormal waves composed of three narrow, sharp peaks. These findings were suggestive of a cardiac valve disorder, which can lead to embolisms. Echocardiography established the diagnosis of infectious endocarditis.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first reported case of infectious endocarditis detected by orbital CDI.
authors.affiliation: Department of Ophthalmology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan. fujioka-sa@mc.pref.osaka.jp
authors.forename: Sayuri
authors.initials: S
authors.lastname: Fujioka
authors.forename: Kaoruko
authors.initials: K
authors.lastname: Karashima
authors.forename: Atsuo
authors.initials: A
authors.lastname: Inoue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takami
authors.forename: Norikiyo
authors.initials: N
authors.lastname: Nishikawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Saito
mesh_terms: D018618:Echocardiography, Doppler, Color; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging*; D009915:Orbit / Q000098:blood supply*; D012161:Retinal Artery / Q000000981:diagnostic imaging*; D012164:Retinal Diseases / Q000175:diagnosis*; D018615:Ultrasonography, Doppler, Color