PMC6409387_01
Mucopurulent conjunctival secretions.
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His ocular examination revealed left eye matted eyelashes, mucopurulent conjunctival secretions, (Fig. 1), corneal edema, hypopyon with fibrinous membrane in pupil, no red glow seen, pupil fixed and non-reactive.
Gram-positive cocci in chains which was noted to be beta-hemolytic.
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Two sets of blood cultures were obtained and exhibited growth of Gram-positive cocci in chains (Fig. 2), which was noted to be beta-hemolytic, and Group C (Fig. 3) Streptococcus dysgalactiae subsp. equisimilis was identified by the clinical microbiology laboratory.
Vitreous debris from B Scan Ultrasound.
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B scan ultrasound of the left eye was done and showed vitreous debris (Fig. 4).
Transesophageal echocardiography (TEE) showed small, mobile vegetation on the non-coronary cusp of the aortic valve and thickened aortic root.
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TTE repeat at day 6 of admission showed aortic valve vegetation that could not exclude an abscess or anterior mitral valve leaflet vegetation. Transesophageal echocardiography (TEE) at day 9 admission showed small, mobile vegetation on the non-coronary cusp of the aortic valve and thickened aortic root (Fig. 5).