A Case of Infective Endocarditis in Which Surgical Removal of Both Eyes Was Inevitable because of Bacterial Endopthalmitis

(Department of Cardiovascular Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan)

Yayoi Takamoto Ryuji Kunitomo Toshiharu Sassa
Hisashi Sakaguchi Syoichiro Hagiwara Shuji Moriyama
Kentaro Takaji Michio Kawasuji
Bacterial endopthalmitis is associated with risk for poor visual prognosis, however, it is rarely combined with infective endocarditis. A 66-year-old man underwent pacemaker implantation and received antibiotic therapy due to persistent fever. A month after the pacemaker implantation, he was admitted to our hospital because of disturbance of vision and consciousness. Disseminated intravascular coagulation (DIC) with decrease of platelet count was also present. His eyes were reddish and swelled, and the conjunctiva were turbid and edematous in both sides. Transesophageal echocardiography demonstrated 18~13mm pendulous verruca originating from the tricuspid annulus. The patient underwent concomitant resection and repair of the tricuspid valve and removal of both infected eyes after DIC treatment. The postoperative course was uneventful and he was discharged from the hospital 43 days after the operation. We conclude that careful observation of the eyes may be needed for patients with infective endocarditis when they have some visual symptoms.
@Jpn. J. Cardiovasc. Surg. 36: 348-351 (2007)