Saved by My Specs: Incidental central retinal vein occlusion uncovering infective endocarditis – A case report

IF 1 Q4 INFECTIOUS DISEASES

IDCases Pub Date : 2026-01-01 Epub Date: 2025-12-26 DOI:10.1016/j.idcr.2025.e02484

Daniel Broderick , Ciara Murray , Padraig McGettrick , James Woo , Emer Kilbride , James McCarthy , Yvonne O’Meara , Varisha Shahzad , Carlos Mejia-Chew

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Abstract

We describe a case of a 74-year-old man with a history of bioprosthetic aortic valve replacement who was diagnosed with Granulicatella adiacens (G. adiacens) infective endocarditis (IE) following an incidental finding of central retinal vein occlusion (CRVO) during a routine optician visit. Despite minimal symptoms on presentation, blood cultures grew G. adiacens, and imaging revealed a 1 × 1.2 cm aortic valve vegetation plus splenic and cerebral embolic complications. Management was complicated by drug-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, microangiopathic thrombocytopenia, anaemia, and possible subacute glomerulonephritis, leading to deferral of surgery until haematological parameters improved. Following a 9-week antibiotic course and stabilisation of platelet counts, he underwent a successful redo aortic valve replacement, highlighting the indolent yet clinically significant nature of G. adiacens IE and the importance of thorough, multidisciplinary care in complex prosthetic valve infections.

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偶然的视网膜中央静脉阻塞发现感染性心内膜炎- 1例报告

我们描述了一个病例74岁的男子与生物假体主动脉瓣置换术的历史，谁被诊断为肉芽肿（G. adiacens）感染性心内膜炎（IE）后偶然发现视网膜中央静脉闭塞（CRVO）在常规验光。尽管出现时症状轻微，但血培养培养出了棘球蚴，影像学显示主动脉瓣1 × 1.2 cm赘生物，并伴有脾和脑栓塞并发症。治疗伴有药物性药物性皮疹伴嗜酸性粒细胞增多和全身症状（DRESS）综合征、微血管病性血小板减少症、贫血和可能的亚急性肾小球肾炎，导致手术推迟至血液学参数改善。经过9周的抗生素治疗和血小板计数稳定后，他进行了成功的主动脉瓣置换术，强调了G. adiacens IE的惰性但临床意义重大的性质，以及在复杂的人工瓣膜感染中进行全面、多学科护理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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