Korean J Med.  2010 Apr;78(4):499-502.

A case of infective endocarditis with endophthalmitis and septic arthritis caused by pneumococcal bacteremia

• Kim JH
• Jo JM
• Shin MS
• Kim MJ
• Chang YJ
• Lim H
• Choi CM

Abstract

Pneumococcal endocarditis accompanied by pneumococcal bacteremia is a rare condition. However, its clinical course is typically aggressive and associated with high morbidity and mortality rates. We report a case of a 67-year-old male who had small cell lung cancer and was undergoing concurrent chemoradiation therapy, and who presented with pneumococcal bacteremia complicated by infective endocarditis, endogenous endophthalmitis, and septic arthritis of the wrist. He presented with fever, sudden blindness, and a systolic cardiac murmur. Blood cultures were positive for penicillin susceptible Streptococcus pneumoniae. Despite appropriate treatment with intravenous and intravitreal antibiotics, destructive changes still appeared in his vitreous, mitral, and aortic valves. He underwent a vitrectomy and mitral and aortic valve replacement. We were able to prevent further embolic events with antibiotics and early surgical management.

Keyword

Streptococcus pneumoniae; Endocarditis; Endophthalmitis; Infectious arthritis

MeSH Terms

Aged
Anti-Bacterial Agents
Aortic Valve
Arthritis, Infectious
Bacteremia
Blindness
Endocarditis
Endophthalmitis
Fever
Heart Murmurs
Humans
Male
Penicillins
Small Cell Lung Carcinoma
Streptococcus pneumoniae
Vitrectomy
Wrist
Anti-Bacterial Agents
Penicillins