# Saved by My Specs: Incidental central retinal vein occlusion uncovering infective endocarditis – A case report

## TL;DR

A 74-year-old man with a prosthetic aortic valve was diagnosed with infective endocarditis after an incidental eye condition revealed during a routine visit.

## Contribution

Highlights the importance of incidental findings in diagnosing complex infective endocarditis cases.

## Key findings

- Central retinal vein occlusion led to the diagnosis of Granulicatella adiacens infective endocarditis.
- Patient required multidisciplinary care due to complications like DRESS syndrome and thrombocytopenia.
- Successful treatment included a 9-week antibiotic course and redo aortic valve replacement.

## Abstract

We describe a case of a 74-year-old man with a history of bioprosthetic aortic valve replacement who was diagnosed with Granulicatella adiacens (G. adiacens) infective endocarditis (IE) following an incidental finding of central retinal vein occlusion (CRVO) during a routine optician visit. Despite minimal symptoms on presentation, blood cultures grew G. adiacens, and imaging revealed a 1 × 1.2 cm aortic valve vegetation plus splenic and cerebral embolic complications. Management was complicated by drug-induced drug rash with eosinophilia and systemic symptoms (DRESS) syndrome, microangiopathic thrombocytopenia, anaemia, and possible subacute glomerulonephritis, leading to deferral of surgery until haematological parameters improved. Following a 9-week antibiotic course and stabilisation of platelet counts, he underwent a successful redo aortic valve replacement, highlighting the indolent yet clinically significant nature of G. adiacens IE and the importance of thorough, multidisciplinary care in complex prosthetic valve infections.