En kvinne i 60-årene med rødt øye, tåkesyn og allmennsymptomer.

摘要

BACKGROUND: Panuveitis is a severe intraocular inflammatory condition that can have infectious, autoimmune, or neoplastic aetiologies. In rare cases, it may represent an early manifestation of systemic infection, such as endogenous endophthalmitis. CASE PRESENTATION: A woman in her early sixties presented with a painful, red eye and reduced vision, initially diagnosed as unilateral panuveitis. Despite topical corticosteroid and antiviral therapy, her symptoms progressed to involve both eyes. Extensive laboratory and imaging work-up was inconclusive, until fever and systemic deterioration led to hospitalisation. Blood cultures revealed Streptococcus gordonii, and imaging showed an abscess in the right masticator space. She later developed similar symptoms in the contralateral eye. Echocardiography confirmed aortic valve endocarditis. The patient underwent valve replacement surgery and prolonged intravenous antibiotic therapy, with subsequent stabilisation of visual and systemic symptoms. INTERPRETATION: This case highlights how panuveitis can masquerade as an isolated ocular condition. Further follow-up revealed endocarditis. It is difficult to determine whether the patient initially had panuveitis or endophthalmitis due to haematogenous seeding of the eye. The case underscores the need for a broad differential diagnosis, including blood cultures and cardiac imaging, and illustrates the importance of early interdisciplinary collaboration when ocular inflammation is accompanied by systemic symptoms.