Streptococcus anginosus-associated endogenous endophthalmitis mimicking fungal endophthalmitis.

Endogenous bacterial endophthalmitis (EE) is recognized as a major cause of visual loss with an associated mortality rate and is a diagnostic challenge in the early stages of the disease, with 16% to 63% of cases being initially misdiagnosed (T. L. Jackson, S. J. Eykyn, E. M. Graham, and M. R. Stanford, Surv. Ophthalmol. 48:403–423, 2003, and M. J. Greenwald, L. G. Wohl, and C. H. Sell, Surv. Ophthalmol. 31:81–101, 1986). We present a case of EE in which the patient presented with an overall clinical picture suggestive of fungal endophthalmitis but was subsequently found to have an atypical gram-positive (Streptococcus anginosus) infective endocarditis.