Group B streptococcus endogenous endophthalmitis presenting as septic arthritis and a homonymous hemianopsia due to embolic stroke.
Overview
abstract
PURPOSE: To report a case of group B streptococcus (GBS) endogenous endophthalmitis in a patient presenting with septic arthritis and a homonymous hemianopsia due to embolic stroke. DESIGN: Observational case report. METHODS: A 75-year-old woman with septic arthritis and a homonymous hemianopsia due to embolic stroke was examined and found to have endogenous GBS endophthalmitis due to bacterial endocarditis. RESULTS: Magnetic resonance imaging showed many septic emboli to the brain, including the left occipital lobe. Fundus examination showed evidence for endogenous endophthalmitis. Blood and urine cultures were positive for GBS. A mitral valve vegetation was presumed to be the cause of the intracranial septic emboli and was demonstrated on transesophageal echocardiography. CONCLUSIONS: Septic arthritis and embolic stroke are suggestive of endocarditis and sepsis. Endogenous endophthalmitis in this case led to transesophageal echocardiography, which was diagnostic for endocarditis.