Rare Manifestations of Streptococcus pneumoniae Infection; The First Case Report in Thailand and Literature Review of Pneumococcal Endophthalmitis and Endocarditis

Peerapat Thaisiam MD*, Pinyo Rattanaumpawan MD, MSCE, PhD*

Affiliation : * Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

We report a case of endogenous endophthalmitis and endocarditis caused by a rare causative organism: Streptococcus pneumoniae. A 69-year-old woman with diabetes mellitus and pre-existing mitral regurgitation presented with acute fever and severe left eye pain. Ophthalmologic examination revealed bilateral endophthalmitis. Blood and vitreous fluid culture grew penicillin-susceptible S. pneumoniae. Transesophageal echocardiogram documented a 5-mm oscillating mass at right coronary cusp of aortic valve. After 4 weeks of combined ceftriaxone and levofloxacin therapy, the patient improved and was later discharged with blindness in her left eye.

Keywords : Streptococcus pneumoniae, Endogenous endophthalmitis, Endocarditis

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