Infective Endocarditis with Uveitis: A Rare Case Report

感染性心內膜炎與葡萄膜炎－病歷報告

李香君(Hsiang-Chun Lee) ； 賴昱宏(Yi-Hon Lai) ； 蔡智禮(Chih-Lee Tsai) ； 顏正賢(Jeng-Hsien Yen) ； 林宗憲(Tsung-Hsien Lin) ； 賴文德(Wen-Ter Lai) ； 許勝雄(Sheng-Hsiung Sheu)

《The Kaohsiung Journal of Medical Sciences》 23卷1期 (2007/01) Pp. 40-44

摘要

我們報導一位51歲糖尿病男性病人，其主述為入院前十天有間歇性寒顫與發燒情形。其無明顯呼叫道，泌尿道，腸胃道及皮膚病兆。血液培養顯現group B β-streptococcus感染。胸前及食道超音波顯示二尖瓣前葉有贅生物。因此他被診斷為感染性心內膜及接受抗生素治療。入院後三天病人發現其視力模糊。眼科裂隙燈檢查顯現前葡萄膜炎。他接受四個月局部類固醇治療後視力逐漸恢復。這個病例提醒我們除了眼內炎外葡萄膜炎也可能與感染性心內膜同時發生。鑑別診斷很重要，一但誤診或錯誤的藥物治療恐惡化病情。

關鍵字

眼內炎 ； 感染性心內膜 ； 葡萄膜炎

並列摘要

We report a case of a 51-year-old diabetic male who presented with a complaint of intermittent chills and fever that he had experienced for 10 days. No obvious respiratory tract, genitourinary tract, gastrointestinal tract, or skin lesions were observed. Blood culture data were positive for group B β-streptococcus. Transthoracic and transesophageal echocardiography revealed vegetation in the anterior leaflet of the mitral valve. The patient was diagnosed with infective endocarditis (IE) and prescribed a parenteral antibiotic. Three days after admission, the patient complained of progressively blurred vision. Slit lamp examination found fine keratic precipitates and aqueous cells in the anterior chambers in both eyes, implying that the patient had uveitis. He was then prescribed a topical steroid for 4 months, and his vision improved gradually. This case is an important reminder that uveitis, not only endophthalmitis, can occur with IE. Treatment for one condition, if misapplied, may worsen the other.

並列關鍵字

endophthalmitis ； infective endocarditis ； uveitis