Endophthalmitis as a first manifestation of right-sided endocarditis in a patient with patent foramen ovale.
Endogenous endophthalmitis is a rare complication of endocarditis, rendering poor visual prognosis. We report a case of a 66-year-old female with renal failure who presented with fever, ocular pain, and purulent eye discharge. After a diagnosis of endogenous endophthalmitis, she was treated with antibiotics and enucleation of the eye. Due to persistent fever and positive blood cultures, a transesophageal echocardiography was undertaken, disclosing a large mural vegetation in the right atrium, catheter-associated vegetations, and a patent foramen ovale. Endocarditis is an uncommon source of endogenous endophthalmitis, and has rarely been associated to right-sided endocarditis and paradoxical septic embolization.
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil. claratude@yahoo.com.
Ana Clara
AC
Rodrigues
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Andrea
A
Ogawa
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Juliana
J
Mota
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Aime
A
Carbone
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Ana Lúcia
AL
Arruda
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Meive
M
Furtado
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
Jairo
J
Pinheiro
Echocardiography Laboratory-InRad, Hospital das Clinicas da FMUSP, Av. Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, SP, 05403900, Brazil.
José L
JL
Andrade
Endocarditis; Endophthalmitis; Patent foramen ovale; Transesophageal echocardiography