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

We describe a case of a 74-year-old man with a history of bioprosthetic aortic valve replacement who was diagnosed with <i>Granulicatella adiacens (G. adiacens)</i> 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 <i>G. adiacens</i>, 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 <i>G. adiacens</i> IE and the importance of thorough, multidisciplinary care in complex prosthetic valve infections.