title: Cecocentral scotoma as the initial manifestation of subacute bacterial endocarditis.
abstract: BACKGROUND
  We report a case of a 67-year-old male who presented with a cecocentral scotoma caused by a septic embolus from subacute bacterial endocarditis (SBE).
  
  
  METHODS
  A 67-year-old man presented with sudden, painless decreased vision in the left eye. A dilated fundoscopic exam, Humphrey visual field test, transthoracic echocardiogram, abdominal computed tomography (CT), and blood cultures were all performed.
  
  
  RESULTS
  A dilated fundoscopic exam revealed temporal segmental optic disc pallor on the left, and Humphrey visual field testing demonstrated a dense left cecocentral scotoma. When the patient developed fever (103. 9°F) and palpitations, transthoracic echocardiogram revealed valvular vegetations, and contrast CT of the abdomen revealed an abscess in the dome of the liver likely due to an infectious thrombus. Blood cultures grew viridians group streptococci in three separate peripheral collections.
  
  
  CONCLUSIONS
  This case illustrates that a sudden cecocentral scotoma may be the initial manifestation of SBE.
authors.affiliation: New York University Langone Medical Center, New York, NY, USA.
authors.forename: Danielle Savitsky
authors.initials: DS
authors.lastname: Strauss
authors.forename: Samuel
authors.initials: S
authors.lastname: Baharestani
authors.forename: Julia
authors.initials: J
authors.lastname: Nemiroff
authors.forename: Kiran
authors.initials: K
authors.lastname: Amesur
authors.forename: David
authors.initials: D
authors.lastname: Howard