A case of infective endocarditis with endophthalmitis and septic arthritis caused by pneumococcal bacteremia

Pneumococcal endocarditis accompanied by pneumococcal bacteremia is a rare condition. However, its clinical course is typically aggressive and associated with high morbidity and mortality rates. We report a case of a 67-year-old male who had small cell lung cancer and was undergoing concurrent chemoradiation therapy, and who presented with pneumococcal bacteremia complicated by infective endocarditis, endogenous endophthalmitis, and septic arthritis of the wrist. He presented with fever, sudden blindness, and a systolic cardiac murmur. Blood cultures were positive for penicillin susceptible Streptococcus pneumoniae. Despite appropriate treatment with intravenous and intravitreal antibiotics, destructive changes still appeared in his vitreous, mitral, and aortic valves. He underwent a vitrectomy and mitral and aortic valve replacement. We were able to prevent further embolic events with antibiotics and early surgical management. (Korean J Med 78:499-502, 2010)