Prado-Serrano A, García-Carmona K

Language: Spanish
References: 11
Page: 280-282
PDF size: 47.35 Kb.

ABSTRACT

Cardiovascular disorders constitute one of the leading causes of death in Mexico and may produce systemic effects in other organs. Bacterial endocarditis is commonly divided into acute and sub acute varieties, depending on the rate of clinical evolution and severity. The eyes are a common site of embolization in endocarditis; the «Roth spot» is the classic ophthalmoscopic sign of sub acute bacterial endocarditis, petechial conjuntival hemorrhages, retinal hemorrhages, retinitis, central or branch retinal arterial occlusion may be seen, but iris nodules are an extraordinary rare manifestation.
We report the case of a 64 year-old woman who underwent a combined triple bypass of her coronary arteries and mitral valve replacement. She developed pain, photophobia and erythema and a creamy white intrastromal iris nodule was detected. Although previous blood cultures had been negative, an embolic infectious process was suspected. The iris lesions were surgically aspirated and actinobacillus actinomycetemcomitans grew out of cultures from the eye. She was treated with parenteral antibiotics resulting in resolution of ocular findings.

REFERENCES

1. 1. Cunha B, Gil V, Lazar J. Acute infective endocarditis. Diagnostic and therapeutic approach. Infect Dis Clin North Am 1996; 10:811-831.

2. 2. Ramonas KM. Iris abscess as an unusual presentation of endogenous endophthalmitis in patient with bacterial endocarditis. Am J Ophthalmol 2003; 135(2):228-9.

3. 3. Stokes DW, O Day DM. Iris nodule and intralenticular abscess associated with Propionibacterium acnes endophthalmitis. Arch Ophthalmol 1992; 110:921-922.

4. 4. Greenlee JE, Mandell GL. Neurological manifestations of infective endocarditis. A review. Stroke 4:958,1973.

5. 5. Romem M, Glasul Z. Late iris abscess after cataract extraction. Am J Ophthalmol 1977; 84:120-121.

6. 6. Kennedy JE, Wise GN. Clinicopathological correlation of retinal lesions. Subacute bacterial endocarditis. Arch Ophthalmol 1965; 74:658.

7. 7. Harrison TR. Principios de Medicina Interna. 14a ed. McGraw-Hill Vol. I, Séptima parte, Sec 2. Endocarditis infecciosa. p. 897,900-902. España, 1998.

8. 8. Kloster FE. Diagnosis and management of complications of prosthetic heart valves. Am J Cardiol 35: 872 1975.

9. 9. Wilson WR, Jaumin PM, Danielson GK y cols. Prosthetic valve endocarditis. Ann Inter Med 1975; 82:751.

10. 10. Kim RW. Ocular manifestations of injection drug use. Infect Dis Clin North Am 2002; 16(3): 607-22.

11. 11. Sivalingam A, Bolling J, Richard E. Ocular Abnormalities in Acquired Heart Disease. En: Duane TD y col. Clinical Ophthalmology. Harper & Row Publishers. Philadelphia 1984. CD -ROM.