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Foveal Micro-embolism in Subacute Bacterial Endocarditis and the Emerging Role of Neutrophil Extracellular Traps: A Case Report and Review of the Literature.

Title: Foveal Micro-embolism in Subacute Bacterial Endocarditis and the Emerging Role of Neutrophil Extracellular Traps: A Case Report and Review of the Literature.
Authors: Muste JC; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Pulido JS; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Fell D; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Xu TT; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Zafar S; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Richards CJ; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Massenzio E; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Aguwa U; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Farrell L; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Department of Pathology, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; Dunn JP; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; The Vickie and Jack Farber Vision Research Center, Philadelphia, PA.; Deaner JD; Mid Atlantic Retina, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.; The Vickie and Jack Farber Vision Research Center, Philadelphia, PA.
Source: Retinal cases & brief reports [Retin Cases Brief Rep] 2026 Mar 30. Date of Electronic Publication: 2026 Mar 30.
Publication Model: Ahead of Print
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101298744 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1937-1578 (Electronic) Linking ISSN: 19351089 NLM ISO Abbreviation: Retin Cases Brief Rep Subsets: MEDLINE
Imprint Name(s): Original Publication: Hagerstown, MD : Wolters Kluwer Health, c2007-
Abstract: Purpose: To report a case of foveal micro-embolism in the setting of subacute bacterial endocarditis following routine dental cleaning.; Methods: Retrospective case report and literature review.; Results: A 45-year-old man presented with subacute bacterial endocarditis and a small distortion of vision his left eye. Aside from renal, splenic, and brain embolization the patient showed no splinter hemorrhages, Roth spots, Osler's nodes, and Janeway lesions. Further examination demonstrated a discrete, non-hemorrhagic lesion which corresponded to hyperreflective foci disrupting the inner and outer retinal layers on optical coherence tomography. This lesion resolved with observation and intravenous antibiotics.; Discussion: We propose this case represents a distinct embolic mechanism mediated by neutrophil extracellular traps. Recognition of this mechanism may help expand our understanding of the spectrum of embolic phenomena in endocarditis.
Competing Interests: Conflict of Interest: No authors have conflicts of interest pertaining to the submitted work. J.D.D Consultant for Abbvie, ANI, Bausch + Lomb, EyePoint, Genentech, Regeneron; Speakers Bureau for ANI, Bausch + Lomb . DF Consultant Bausch + Lomb. All other authors have no conflicts of interest to disclose.
Contributed Indexing: Keywords: bacterial endophthalmitis; dental cleaning; embolus
Entry Date(s): Date Created: 20260330 Latest Revision: 20260330
Update Code: 20260330
DOI: 10.1097/ICB.0000000000001904
PMID: 41910722
Database: MEDLINE

Journal Article