Author + information
- Received January 27, 2012
- Revision received February 13, 2012
- Accepted February 23, 2012
- Published online September 18, 2012.
A 69-year-old woman with mitral valve prolapse presented with 2-day history of fever, painful, red right eye, and decreased vision. Her right conjunctiva was injected, associated with a hypopyon (A, arrowheads). An erythematous, nontender macular lesion found on her left palm (B, arrows) was highly suggestive of a Janeway lesion. A loud pansystolic murmur was audible at the apex. Transesophageal echocardiography revealed vegetation (veg) measuring 10 mm in maximal dimension (C, and Online Video 1) on a myxomatous mitral valve leaflet, associated with severe mitral regurgitation. Three consecutive blood cultures were positive for Staphylococcus aureus.
Endogenous bacterial endophthalmitis is a rare but potentially vision-threatening medical emergency that results from bacterial seeding of the eye, with endocarditis being the most common cause (1). The diagnosis should be considered in a patient with a painful eye or decreased vision in the setting of bacteremia.
Dr Looi acknowledges support from the Overseas Fellowship Award from the National Heart Foundation New Zealand. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 27, 2012.
- Revision received February 13, 2012.
- Accepted February 23, 2012.
- American College of Cardiology Foundation