Cecocentral scotoma as the initial manifestation of subacute bacterial endocarditis

Autor: Danielle Savitsky Strauss, Samuel Baharestani, Julia Nemiroff, et al
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Clinical Ophthalmology, Vol 2011, Iss default, Pp 287-290 (2011)
Druh dokumentu: article
ISSN: 1177-5467
1177-5483
Popis: Danielle Savitsky Strauss, Samuel Baharestani, Julia Nemiroff, Kiran Amesur, David HowardNew York University Langone Medical Center, New York, NY, USAIntroduction: We report a case of a 67-year-old male who presented with a cecocentral scotoma caused by a septic embolus from subacute bacterial endocarditis (SBE).Methods: A 67-year-old man presented with sudden, painless decreased vision in the left eye. A dilated fundoscopic exam, Humphrey visual field test, transthoracic echocardiogram, abdominal computed tomography (CT), and blood cultures were all performed.Results: A dilated fundoscopic exam revealed temporal segmental optic disc pallor on the left, and Humphrey visual field testing demonstrated a dense left cecocentral scotoma. When the patient developed fever (103.9°F) and palpitations, transthoracic echocardiogram revealed valvular vegetations, and contrast CT of the abdomen revealed an abscess in the dome of the liver likely due to an infectious thrombus. Blood cultures grew viridians group streptococci in three separate peripheral collections.Conclusion: This case illustrates that a sudden cecocentral scotoma may be the initial manifestation of SBE. Keywords: endocarditis, scotoma, streptococcal infections, visual fields
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