title: Rare manifestations of Streptococcus pneumoniae infection; the first case report in Thailand and literature review of pneumococcal endophthalmitis and endocarditis.
abstract: We report a case of endogenous endophthalmitis and endocarditis caused by a rare causative organism: Streptococcus pneumoniae. A 69-year-old woman with diabetes mellitus and pre-existing mitral regurgitation presented with acute fever and severe left eye pain. Ophthalmologic examination revealed bilateral endophthalmitis. Blood and vitreous fluid culture grew penicillin-susceptible S. pneumoniae. Transesophageal echocardiogram documented a 5-mm oscillating mass at right coronary cusp of aortic valve. After 4 weeks of combined ceftriaxone and levofloxacin therapy, the patient improved and was later discharged with blindness in her left eye.
authors.forename: Peerapat
authors.initials: P
authors.lastname: Thaisiam
authors.forename: Pinyo
authors.initials: P
authors.lastname: Rattanaumpawan
mesh_terms: D000368:Aged; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D009877:Endophthalmitis / Q000382:microbiology*; D005260:Female; D006801:Humans; D011008:Pneumococcal Infections / Q000175:diagnosis*; D013785:Thailand