Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis

Dinani, Amreen; Ktaich, Nessrine; Urban, Carl; Rubin, David

doi:10.1099/jmm.0.012658-0

Cited by 8 publications

(3 citation statements)

References 8 publications

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“…[2,5] Among these cases, only 12 were caused by S mitis, and only 2 were caused by endocarditis, including our case (Table 1). [4,9,[18][19][20][21][22][23][24] Although S mitis has a low virulence, it can cause infections such as bacteremia and endocarditis in patients with risk factors such as older age, cancer, and immunosuppression. [25] Of the 12 cases of endogenous endophthalmitis caused by S mitis, 11 had immunosuppressive factors, such as advanced age, diabetes mellitus, or leukemia, with the exception of a 3-year-old patient.…”

Section: Discussionmentioning

confidence: 99%

Endogenous endophthalmitis caused by Streptococcus mitis: A case report

Nakayama,

Itagaki,

Abe

et al. 2024

Medicine

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Rationale: Endogenous endophthalmitis is a rare disease caused by hematogenous intraocular metastasis of bacteria from an infectious source. Diagnosing endogenous endophthalmitis is challenging for non-ophthalmologists. However, ophthalmic diseases can cause irreversible vision loss, making prompt diagnosis and treatment critical. Here we present a rare case of endogenous endophthalmitis initially misdiagnosed as a cataract. Patient concerns: An 84-year-old Japanese man presented to the emergency department with fever and dysmotility. The patient was aware of a left subconjunctival hemorrhage and cloudy cornea upon arrival at the hospital, but he misunderstood it as a fall-induced subconjunctival hemorrhage and age-related cataracts. Diagnoses: On the day following admission, petechial hemorrhage on the eyelid conjunctiva and the detection of Streptococcus mitis in the blood culture results led us to suspect endophthalmitis rather than cataracts. A definitive diagnosis of endophthalmitis was made through ophthalmologic examinations, and endophthalmitis was considered secondary to endocarditis. Interventions: Subsequently, antimicrobial treatment was continued. Outcomes: However, the patient developed myocardial infarction and died on the ninth day of hospitalization. Lessons: Two important lessons were learned from the examination of this case of endogenous endophthalmitis caused by S mitis. First, endophthalmitis and cataracts can be misdiagnosed. Because the symptoms of endophthalmitis and cataracts, such as decreased vision, photophobia, and blurred vision, are similar, the eye must be cautiously examined. Second, endocarditis caused by S mitis may lead to endogenous endophthalmitis. Although S mitis is not pathogenic, endogenous endophthalmitis may occur in patients with certain risk factors, such as older age, cancer, and immunosuppression.

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Section: Discussionmentioning

confidence: 99%

Endogenous endophthalmitis caused by Streptococcus mitis: A case report

Nakayama,

Itagaki,

Abe

et al. 2024

Medicine

View full text Add to dashboard Cite

show abstract

“…5) [1,7] Endogenous endophthalmitis is a rare complication of infective endocarditis, and has been decreasing due to the availability of effective antibiotics. [8] To optimize visual outcome, early diagnosis and treatment are essential. [7,8] Over recent decades, advances in hygienic standards, improved microbiologic and surgical techniques, development of powerful antimicrobial drugs, and the introduction of intravitreal antibiotic therapy have led to a decreased incidence and improved management of endophthalmitis.…”

Section: Introductionmentioning

confidence: 99%

“…[8] To optimize visual outcome, early diagnosis and treatment are essential. [7,8] Over recent decades, advances in hygienic standards, improved microbiologic and surgical techniques, development of powerful antimicrobial drugs, and the introduction of intravitreal antibiotic therapy have led to a decreased incidence and improved management of endophthalmitis. [1,7] However, endophthalmitis still represents a serious clinical problem.…”

Section: Introductionmentioning

confidence: 99%