CANDIDA-TROPICALIS MULTIFOCAL ENDOPHTHALMITIS AS THE ONLY INITIAL MANIFESTATION OF PACEMAKER ENDOCARDITIS

PURPOSE: To document a case of Candida tropicalis endophthalmitis as t he only manifestation of pacemaker endocarditis. METHODS: We examined a 75 year-old man with diabetes mellitus who was initially examined fo r bilateral multifocal endophthalmitis complicating endocarditis 2 yea rs after a permanent pacemaker for sick sinus syndrome was implanted. RESULTS: Transesophageal echocardiography showed a large vegetation wi th a 3-cm diameter attached to the pacing electrode in the right ventr icle. Six consecutive blood cultures grew C tropicalis. CONCLUSIONS: O cular involvement, including multifocal endophthalmitis, may occur as the only manifestation of C tropicalis endocarditis, complicating an i ntravenous permanent pacemaker.