Infective Endocarditis Presenting as Endogenous Endophthalmitis and Multiple Cerebral Infarcts

Abstract

A 60-year-old housewife as admitted with fever, pain and redness in her right eye for 2 days. She had right eye redness with haziness of the cornea, white fibrinous material in the anterior chamber, and vitreous in the posterior segment. She was evaluated and found to have Endogenous Endophthalmitis (EE) with multiple cerebral infarcts due to methicillin-sensitive coagulase-negative Staphylococcus endocarditis. The patient received intravitreal injections of vancomycin and ceftazidime. She received cefazolin 2 g thrice daily intravenously. The plan of vitrectomy was suggested as per the advice from the ophthalmologist but the relatives opted for conservative management. The patient went into multiorgan failure with disseminated intravascular coagulation and despite all efforts, she succumbed to her illness. Our patient had two extracardiac manifestations of IE together. The presence of any of these manifestations should raise suspicion of infective endocarditis (IE). We report a case of native mitral valve methicillin-sensitive coagulase-negative Staphylococcus endocarditis presenting with extracardiac manifestations. Our case reminds readers to be aware of endocarditis when evaluating patients with extracardiac manifestations like EE.