scholarly journals Streptococcus dysgalactiae endocarditis presenting as acute endophthalmitis

2012 ◽  
Vol 4 (1) ◽  
pp. 16 ◽  
Author(s):  
Angelina Su-Min Yong ◽  
Su Yin Lau ◽  
Tsung Han Woo ◽  
Jordan Yuanzhi Li ◽  
Tuck Yean Yong
Keyword(s):  
Visual Acuity ◽  
Infective Endocarditis ◽  
Mitral Valve ◽  
Type I Diabetes ◽  
Case Reports ◽  
Endogenous Endophthalmitis ◽  
Ocular Infection ◽  
Type I ◽  
Streptococcus Dysgalactiae ◽  
Group A

Endogenous endophthalmitis is a rare ocular infection affecting the vitreous and/or aqueous humours. It is associated with poor visual prognosis and its commonest endogenous aetiology is infective endocarditis. The causative organisms of endogenous endophthalmitis complicating endocarditis are mainly Group A or B streptococci. The identification of Group C and G streptococci such as <em>Streptococcus dysgalactiae </em>is comparatively uncommon and has only been reported in a few case reports or series. We therefore report a case of infective endocarditis caused by <em>Streptococcus dysgalactiae </em>first presenting with endogenous endophthalmitis, the most likely source being bilateral feet osteomyelitis in a patient with type I diabetes. The patient was treated with a course of intravenous benzylpenicillin, intravitreal antibiotics, bilateral below knee amputations and mitral valve replacement. She survived all surgical procedures and regained partial visual acuity in the affected eye.

Vitreoretinal Surgery in Diabetic Patients on Hemodialysis

1997 ◽  
Vol 7 (3) ◽  
pp. 283-287 ◽  
Author(s):  
J. Nawrocki ◽  
W. Chrzanowski ◽  
D. Koch ◽  
K. Dziegielewski
Keyword(s):  
Visual Acuity ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Type I Diabetes ◽  
Vitreoretinal Surgery ◽  
Final Visual Acuity ◽  
Diabetic Patients ◽  
Type I ◽  
First Results ◽  
Pars Plana

The present paper reports our first results after pars plana vitrectomy in patients with diabetic retinopathy and hemodialysis with a follow-up of 6 to 24 months. Between January 1992 and October 1994 we performed vitreoretinal surgery with silicone oil tamponade in nine eyes of seven patients with diabetic nephropathy on hemodialysis. All patients had had type I diabetes for 19–32 years. Over the observation period the retina was completely attached in eight eyes. Final visual acuity of 0.1 - 0.7 was attained in four eyes, 0.06 two, hand movements in one eye. Two eyes had no useful final visual acuity because of redetachment of the retina or secondary glaucoma with rubeosis iridis. The small number of complications shows that pars plana vitrectomy can be done in diabetic patients with nephropathy on hemodialysis. This significantly improves their quality of life

scholarly journals Mitral valve repair for infective endocarditis: Kobe experience

2020 ◽  
Vol 28 (7) ◽  
pp. 384-389
Author(s):  
Yukikatsu Okada ◽  
Takeo Nakai ◽  
Takashi Muro ◽  
Hisato Ito ◽  
Yu Shomura
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Event Free Survival ◽  
Valve Repair ◽  
Free Survival ◽  
Autologous Pericardium ◽  
Ring Annuloplasty ◽  
Group A ◽  
Group B

Objectives We retrospectively analyzed our experience of mitral valve repair for native mitral valve endocarditis in a single institution. Methods From January 1991 to October 2011, 171 consecutive patients underwent surgery for infective endocarditis. Of these, 147 (86%) had mitral valve repair. At the time of surgery, 98 patients had healed (group A) and 49 had active infective endocarditis (group B). Repair procedures included resection of all infected tissue and thick restricted post-infection tissue, leaflet and annulus reconstruction with treated autologous pericardium, chordal reconstruction with polytetrafluoroethylene sutures, and ring annuloplasty if necessary. Fifty-two (35%) patients required concomitant procedures. The study endpoints were overall survival, freedom from reoperation, and freedom from valve-related events. The median follow-up was 78 months. Results There was one hospital death (hospital mortality 0.7%). Survival at 10 years was 88.5% ± 3.5% with no significant difference between the two groups ( p = 0.052). Early reoperation was required in 4 patients in group B due to persistent infection or procedure failure. Freedom from reoperation at 5 years was 99% ± 1.0% in group A and 89.6 ± 4.0% in group B ( p = 0.024). Event-free survival at 10 years was 79.3% ± 4.8% (group A: 83.4% ± 5.9%, group B: 72.6% ± 6.9%, p = 0.010). Conclusions Mitral valve repair was highly successful using autologous pericardium, chordal reconstruction, and ring annuloplasty if required. Long-term results were acceptable in terms survival, freedom from reoperation, and event-free survival. Mitral valve repair is recommended for mitral infective endocarditis in most patients.

Malignant melanoma followed by the development of type I diabetes and thyroid dysfunction caused by immune checkpoint inhibitors : Two case reports

Skin Cancer ◽  
2018 ◽  
Vol 33 (1) ◽  
pp. 22-29
Author(s):  
Aya TAKAHASHI ◽  
Masato AMAKATA ◽  
Yoshiki SATO ◽  
Megumi YOKOYAMA ◽  
Kaduhisa HIRAHARA ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Thyroid Dysfunction ◽  
Checkpoint Inhibitors ◽  
Type I Diabetes ◽  
Case Reports ◽  
Type I

scholarly journals Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases

2020 ◽  
Author(s):  
Masaaki Yoshida ◽  
Shunji Yokokura ◽  
Takashi Nishida ◽  
Kiyofumi Mochizuki ◽  
Takashi Suzuki ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Literature Review ◽  
Medical Condition ◽  
Group B Streptococcus ◽  
Case Series ◽  
Endogenous Endophthalmitis ◽  
Ocular Infection ◽  
Invasive Infection ◽  
Initial Visual Acuity ◽  
Group B

Abstract Background: Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Methods: Retrospective case series and literature review Results: In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection focus was endocarditis (37%). Conclusions: DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

scholarly journals Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases

2020 ◽  
Author(s):  
Masaaki Yoshida ◽  
Shunji Yokokura ◽  
Takashi Nishida ◽  
Kiyofumi Mochizuki ◽  
Takashi Suzuki ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Literature Review ◽  
Medical Condition ◽  
Group B Streptococcus ◽  
Case Series ◽  
Endogenous Endophthalmitis ◽  
Ocular Infection ◽  
Invasive Infection ◽  
Initial Visual Acuity ◽  
Group B

Abstract Background: Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Methods: Retrospective case series and literature review Results: In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection site was endocarditis (37%). Conclusions: DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

scholarly journals Acute Severe Mitral Regurgitation Secondary to Haemophilus parainfluenzae Infective Endocarditis

2020 ◽  
pp. 92-96
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Case Reports ◽  
Severe Mitral Regurgitation ◽  
Haemophilus Parainfluenzae ◽  
Intravenous Antibiotics

Haemophilus parainfluenzae is an exceedingly rare cause of infective endocarditis, with only a few case reports describing its potential invasiveness. This case reports on a 25-year-old female who was admitted with a fever and was subsequently found to have H. parainfluenzae endocarditis. She was managed with intravenous antibiotics and mitral valve replacement.

scholarly journals Endogenous endophthalmitis caused by group B streptococcus; case reports and review of 35 reported cases

2019 ◽  
Author(s):  
Masaaki Yoshida ◽  
Shunji Yokokura ◽  
Takashi Nishida ◽  
Kiyofumi Mochizuki ◽  
Takashi Suzuki ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Literature Review ◽  
Medical Condition ◽  
Group B Streptococcus ◽  
Case Series ◽  
Endogenous Endophthalmitis ◽  
Ocular Infection ◽  
Invasive Infection ◽  
Initial Visual Acuity ◽  
Group B

Abstract Background: Group B streptococcus (GBS), a gram-positive coccus that occasionally causes neonatal sepsis or invasive infection in the elderly, has been considered a rare cause of endogenous bacterial endophthalmitis (EBE). However, the number of invasive GBS infections is increasing, particularly in elderly patients with underlying conditions such as diabetes mellitus (DM), cardiovascular disease and cancer. We report 6 cases of EBE caused by GBS and review the literature. Methods: Retrospective case series and literature review Results: In the current case series, 6 eyes of 6 patients developed EBE caused by GBS. The average age was 73.5 years. The focus of infection included the urinary tract, cellulitis, arthritis, peritonitis, catheter-associated infection and endocarditis. Four patients had DM. While all 6 strains were sensitive to β-lactams (penicillins and cephems), 4 strains were resistant to levofloxacin (no data for 1 isolate). Each case was treated with the systemic antibiotic to which the individual strain was sensitive. All cases showed poor visual acuity at presentation (decimal visual acuity: less than 0.03). Vitrectomy with intravitreal antibiotics injection was performed in 4 cases. Visual acuity recovered in 4 cases and did not recover in 2 cases, even after vitrectomy. The literature review of 53 eyes of 41 patients revealed that 60% of eyes finally lost all vision, and death occurred in 2 cases. Initial visual acuity of less than counting fingers was associated with a final outcome of lost vision. Of 41 patients, 13 (32%) had DM as an underlying medical condition. The most common extra-ocular infection site was endocarditis (37%). Conclusions: DM is common in patients with EBE caused by GBS. While the 4 cases in the current report had a relatively good visual acuity outcome, despite poor initial visual acuity, the literature review indicated that EBE caused by GBS is generally a severe condition with a poor prognosis. The current study also indicates the importance of considering the possibility of endocarditis on encountering EBE caused by GBS.

scholarly journals An unusual case report of mitral valve apparatus sparing left atrial appendage vegetation presenting as endogenous endophthalmitis

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Rupesh Kumar ◽  
Vidur Bansal ◽  
Vikram Halder ◽  
Nirupan Sekhar Chakraborty ◽  
Krishna Prasad Gourav
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Treatment Algorithm ◽  
Atrial Appendage ◽  
Definitive Treatment ◽  
Endogenous Endophthalmitis ◽  
Cardiac Symptoms ◽  
Systemic Embolization

Abstract Background Ocular manifestations of infective endocarditis are nonspecific and rare. Endophthalmitis, retinal artery occlusion, Roth spots and vitreal and retinal infiltrations can all be seen with infective endocarditis. Also, infective endocarditis involving the left atrial appendage with no involvement of the mitral valve apparatus is a rarity. Case presentation Here we report a case of infective endocarditis of the heart involving the left atrial appendage presenting with features of endogenous endophthalmitis which ultimately progressed to phthisis bulbi with subtle cardiac symptoms in a previous healthy young adult. Conclusion Infective endocarditis involving the left chambers of the heart carries an inherent high risk of systemic embolization. Panophthalmitis which is considered to be the most severe form of endogenous endophthalmitis is a rare presenting feature. Although a definitive treatment algorithm is lacking, early surgery and parenteral antibiotics along with local antibiotic injections could help to save the vision.

Difference in Outcome Following Surgery for Native Aortic and Mitral Valve Infective Endocarditis

2018 ◽  
Vol 67 (08) ◽  
pp. 652-658 ◽  
Author(s):  
Tuukka Kaartama ◽  
Shahab Nozohoor ◽  
Malin Johansson ◽  
Johan Sjögren ◽  
Pedro Timane ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Long Term Results ◽  
Native Valve ◽  
Group A ◽  
Short And Long Term ◽  
The Mean ◽  
Group B

Background We investigated differences in clinical presentation, microbiology, and short- and long-term results according to the affected valve in patients who underwent surgery for left-sided native valve infective endocarditis (IE). Methods This was a single-center retrospective study of 117 patients with isolated mitral valve IE (group M) and 140 patients with isolated aortic valve IE (group A) who underwent surgery between 1998 and 2015. Results The mean age of patients in group M was 62 ± 14 years, whereas in group A the patients were 56 ± 14 years old (p = 0.001). There were 61 females (52% of patients) in group M and 31 females (22% of patients) in group A (p < 0.001). Abscesses were more common in group A than in group B. Staphylococcus aureus was more frequent in group M (47%, n = 55) than in group A (21%, n = 30; p < 0.001). The length of time from symptom onset to surgery was longer in group A than in group M, but the time from diagnosis to surgery was shorter in group A than in group M. Ninety-day mortality was similar in group M and group A in patients operated within 48 hours after diagnosis, but in patients who were operated more than 48 hours after diagnosis the 90-day mortality was 15% in group M and 3% in group A (p = 0.006). Conclusion There were considerable differences in preoperative characteristics, microbiology, timing of surgery, and outcomes between patients who underwent surgery for isolated aortic valve IE and those who were operated for isolated mitral valve IE.

scholarly journals Atteintes Oculaires Au Cours Du Syndrome De Wolfram À Propos De Deux Cas Et Revue De La Littérature

2017 ◽  
Vol 13 (27) ◽  
pp. 269
Author(s):  
Abba Kaka H.Y ◽  
Guirou N. ◽  
Berete C.R. ◽  
Amza A. ◽  
Daou M.
Keyword(s):  
Visual Acuity ◽  
Optic Atrophy ◽  
Neurodegenerative Disorder ◽  
Age Of Onset ◽  
Type I Diabetes ◽  
Hypogonadotropic Hypogonadism ◽  
Wolfram Syndrome ◽  
Type I ◽  
Diabetic Ketosis ◽  
The Right

Introduction: Wolfram syndrome is an autosomal recessive neurodegenerative disorder. Diabetes mellitus and juvenile bilateral optic atrophy are its major signs. It is recognized that this association, which started in childhood or during adolescence, is sufficient to diagnose Wolfram syndrome. Optic atrophy occurs in 98% to 100% of cases with an average age of onset of 11 years. We reported a study of two confirmed cases referred by the internal medicine department. Observations: Case 1: A 23- year-old woman, deaf and dumb by birth, went through a diabetic ketosis test. Ophthalmologic examination showed reduced visual acuity in the fingers at 5 meters P2 in both eyes. Also, the fundus of the eye showed bilateral atrophic papillary palpation with no signs of retinopathy. She had deafness of deep perception and hypogonadotropic hypogonadism. Deafness, diabetes, optic atrophy, and hypogonadism led to the diagnosis. Case 2: A 21-year-old man born from a first-degree consanguineous marriage serves as a supplement to the management of diabetes. The visual acuity was at counting fingers at 1m to the right eye and sees the hand move to 0.5 m to the left eye. On examination at the slit lamp, it had a bilateral dense cataract. After phacoexeresis, the base revealed bilateral optic atrophy. Ultrasound of the urinary tree showed hypotonia of the renal cavities and a neurogenic bladder. Also, audiometry showed mild sensory deafness. The diagnosis of Wolfram syndrome was made in front of the tetrad: diabetes, optic atrophy, deafness, and urinary signs. Discussion: Wolfram syndrome may be familial or sporadic. The gene however is located on the short arm of chromosome 4. Optic atrophy is secondary to the involvement of pre-genetic fibers, and it is characterized initially by temporal palpation of the papilla. The evolution towards diffuse whitish discoloration occurs in a few months or years with the gradual establishment of a blindness around the age of 17 to 30 years. Conclusion: Wolfram syndrome is a clinical entity characterized by clinical and genetic polymorphism. This diagnosis should be considered in the presence of any type I diabetes associated with optic atrophy in children

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