Central Retinal Artery Occlusion from Streptococcus Gallolyticus Endocarditis

Serras-Pereira, R; Hipólito-Fernandes, D; Azevedo, L; Vieira, L

http://hdl.handle.net/10400.17/4053

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Authors

Serras-Pereira, R

Hipólito-Fernandes, D

Azevedo, L

Vieira, L

Abstract(s)

Central retinal artery occlusion (CRAO) is a rare but blinding disorder. We present a case of a 81-year-old woman with multiple cardiovascular comorbidities admitted to the emergency department due to sudden, painless vision loss on left eye (oculus sinister (OS)) on awakening. The patient also reported long standing fatigue associated with effort that started 4 months before admission. She presented best corrected visual acuity of counting fingers OS. Funduscopy OS revealed macular oedema with cherry red spot pattern. Blood cultures came positive for Streptococcus gallolyticus in the context of a bacteremia and native mitral valve vegetation identified on transoesophageal echocardiography. CRAO of embolic origin was admitted in the context of an infective endocarditis. CRAO can be the first manifestation of a potentially fatal systemic condition and thus multidisciplinary approach is warranted with close collaboration between ophthalmologists and internists in order to provide proper management and the best possible treatment.

Keywords

CHLC OFT CHLC MED Aged, 80 and over Female Humans Acetazolamide / administration & dosage Administration, Intravenous Administration, Ophthalmic Administration, Oral Anti-Bacterial Agents / administration & dosage Antihypertensive Agents / administration & dosage Ceftriaxone / administration & dosage Echocardiography Endocarditis, Bacterial / complications Endocarditis, Bacterial / diagnosis* Endocarditis, Bacterial / drug therapy Endocarditis, Bacterial / microbiology Hypothalamic Area, Lateral Isosorbide Dinitrate / administration & dosage Mitral Valve / diagnostic imaging Mitral Valve / microbiology Retina / diagnostic imaging Retinal Artery Occlusion / drug therapy Retinal Artery Occlusion / microbiology* Streptococcal Infections / complications Streptococcal Infections / diagnosis* Streptococcal Infections / drug therapy Streptococcal Infections / microbiology Streptococcus gallolyticus / isolation & purification* Tomography, Optical Coherence Treatment Outcome