scholarly journals Infective Endocarditis with Multiple Mycotic Aneurysms Mimicking Vasculitis: A Case Report

2012 ◽  
Vol 23 (3) ◽  
pp. e67-e68 ◽  
Author(s):  
Ji Hyeon Park ◽  
Hye Ryoun Jang ◽  
Jung Eun Lee ◽  
Wooseong Huh ◽  
Dae Joong Kim ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mycotic Aneurysm ◽  
Skin Lesions ◽  
Neurological Complications ◽  
Blood Cultures ◽  
Renal Infarction ◽  
Viridans Streptococci ◽  
Mycotic Aneurysms ◽  
Mitral Valve Vegetation

The manifestation of infective endocarditis often resembles vasculitis. Approximately one in five infective endocarditis cases are referred initially to a nephrologist because of abnormal renal function or abnormal urinalysis; therefore, infection should be ruled out before diagnosing vasculitis.A case involving a patient with infective endocarditis who presented with migrating skin lesions, renal infarction and multiple pseudoaneurysms is reported. Echocardiography revealed mitral valve vegetation and viridans streptococci were identified in peripheral blood cultures. Although mitral valve annuloplasty and an aneurysm ligation operation were performed with proper antibiotic treatment, the remaining mycotic aneurysm progressed and caused neurological complications. The patient was cured completely after reoperation.

Neurological Complications of Infective Endocarditis

2017 ◽  
Author(s):  
Jonah Grossman ◽  
Tanzila Shams ◽  
Cathy Sila
Keyword(s):  
Infective Endocarditis ◽  
Hospital Admissions ◽  
Decompensated Heart Failure ◽  
Neurological Complications ◽  
Multidrug Resistant ◽  
Viridans Streptococci ◽  
Septic Embolization ◽  
Increased Risk ◽  
Risk Of Rupture ◽  
Mycotic Aneurysms

Infective endocarditis is the fourth leading cause of life-threatening infections, accounting for 40,000 annual U.S. hospital admissions. Due to decline in rheumatic heart disease, a shift in causative organisms from viridans streptococci to S. aureus, Group D Streptococcus, and multidrug-resistant species has been observed. The spectrum of neurological complications ranges widely from cerebrovascular pathologies-including septic embolization, mycotic aneurysms, and intracerebral hemorrhages-to seizures, meningitis, cerebritis, and abscess. Transthoracic echocardiogram remains the standard for initial investigation whereas CT scans, MRI with DWI sequence, and cerebral angiograms are useful for exploring neurological complications. Antibiotic regimens, tailored to culprit organisms, should be initiated early after obtaining blood cultures and continued for 4 to 6 weeks. Antithrombotic treatment may pose increased risk for intracerebral hemorrhage, even in the absence of mycotic aneurysms (MA). Unruptured MA must be treated according to risk of rupture and overall health of the patient. MAs either at risk or previously ruptured should be secured by neurosurgical or endovascular means. Early cardiac surgery is a viable option for prevention of septic embolization for high-risk cardiac diseases such as perivalvular abscess and infection with resistant organisms, but may increase mortality rates for those with decompensated heart failure.

Stroke in Patients with Infective Endocarditis: A 15-Year Single-Center Cohort Study

2018 ◽  
Vol 80 (3-4) ◽  
pp. 171-178 ◽  
Author(s):  
Gui-fang Cao ◽  
Wei Liu ◽  
Qi Bi
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Hemorrhagic Stroke ◽  
Hospital Deaths ◽  
Independent Risk Factors ◽  
The Mean ◽  
Medical University ◽  
The Relationship ◽  
Rheumatic Valvular Disease ◽  
Mitral Valve Vegetation

Objective: To explore the relationship between infective endocarditis (IE) and stroke. Methods: The clinical data of patients diagnosed with IE from January 2003 to December 2017 in Beijing Anzhen Hospital Affiliated to Capital Medical University were retrospectively analyzed. Results: A total of 861 patients (mean age: 40.79 ± 16.27 [SD]) with IE was recruited. Vegetations were confirmed in 97.32% of all the patients, among whom 296 were diagnosed with congenital heart disease and another 53 with rheumatic valvular disease. The most common pathogens were Streptococcus, Staphylococcus, and various types of fungi (13.12, 7.31, and 1.16% respectively). Out of the 138 patients diagnosed with stroke, 101 cases were of ischemic stroke, 23 cases were of hemorrhagic stroke, and 12 cases were of concurrent ischemic and hemorrhagic stroke. There were 31 patients who had infarction lesions in more than 2 vascular systems. The mean age of stroke patients was significantly higher than that of patients without stroke (45.76 ± 17.88 vs. 39.83 ± 15.77, p = 0.000). The incidence of mitral valve vegetation (57.24 vs. 43.01%, p = 0.002), atrial fibrillation (4.34 vs. 1.38%, p = 0.018), fungal infection (2.89 vs. 0.83%, p = 0.038) in patients with stroke was significantly higher than those without stroke. Mitral valve vegetation (OR 1.648; 95% CI 1.113–2.442) and age (OR 1.019; 95% CI 1.007–1.032) were independent risk factors for stroke in IE patients. Stroke increased the risk of hospital deaths (OR 7.673 95%CI 3.634–16.202). Conclusion: Stroke is a common complication of IE. Mitral valve vegetation and old age may incerease the risk of stroke in patients with IE.

scholarly journals Aerococcus viridansNative Valve Endocarditis

2013 ◽  
Vol 24 (3) ◽  
pp. 155-158 ◽  
Author(s):  
Wenwan Zhou ◽  
Vanessa Nanci ◽  
Andreanne Jean ◽  
Amir H Salehi ◽  
Fahad Altuwaijri ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Infective Endocarditis ◽  
Mitral Valve ◽  
Surgical Approach ◽  
Clinical Presentation ◽  
Blood Cultures ◽  
Human Pathogen ◽  
Aerococcus Viridans ◽  
Time To Diagnosis ◽  
Echocardiographic Findings

Aerococcus viridansis an infrequent human pathogen and few cases of infective endocarditis have been reported. A case involving a 69-year-old man with colon cancer and hemicolectomy 14 years previously, without recurrence, is reported. A diagnosis of native mitral valve endocarditis was established on the basis of clinical presentation, characteristic echocardiographic findings and pathological specimen examination after urgent valve replacement.A viridansendocarditis appears to be particularly virulent, requiring a surgical approach in four of 10 cases reported and death in one of nine. Given the aggressive nature ofA viridansendocarditis and the variable time to diagnosis (a few days to seven months), prompt recognition of symptoms and echocardiography, in addition to blood cultures, should be performed when symptoms persist.

Infective endocarditis due to Streptococcus agalactiae giant mitral valve vegetation

2013 ◽  
pp. 1096-1096 ◽  
Author(s):  
Lech Paluszkiewicz ◽  
Jochen Börgermann ◽  
Edyta Płońska-Gościniak ◽  
Jan Gummert
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Streptococcus Agalactiae ◽  
Mitral Valve Vegetation

scholarly journals Ruptured Intracranial Mycotic Aneurysm in Infective Endocarditis: A Natural History

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Isabel Kuo ◽  
Theodore Long ◽  
Nathan Nguyen ◽  
Bharat Chaudry ◽  
Michael Karp ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Natural History ◽  
Intracranial Aneurysms ◽  
Mycotic Aneurysm ◽  
Treatment Modalities ◽  
Intraparenchymal Hemorrhage ◽  
Retrospective Case ◽  
Aneurysm Clipping ◽  
History Of ◽  
Mycotic Aneurysms

Mycotic aneurysms are a rare cause of intracranial aneurysms that develop in the presence of infections such as infective endocarditis. They account for a small percentage of all intracranial aneurysms and carry a high-mortality rate when ruptured. The authors report a case of a 54-year-old man who presented with infective endocarditis of the mitral valve and acute stroke. He subsequently developed subarachnoid hemorrhage during antibiotic treatment, and a large intracranial aneurysm was discovered on CT Angiography. His lesion quickly progressed into an intraparenchymal hemorrhage, requiring emergent craniotomy and aneurysm clipping. Current recommendations on the management of intracranial Mycotic Aneurysms are based on few retrospective case studies. The natural history of the patient's ruptured aneurysm is presented, as well as a literature review on the management and available treatment modalities.

scholarly journals Infective Endocarditis Caused by Group G Streptococcus with Multiple Cerebral Emboli

2003 ◽  
Vol 46 (3) ◽  
pp. 125-127 ◽  
Author(s):  
Ilknur Erdem ◽  
Pasa Goktas ◽  
Refik Demirtunc ◽  
Aysun Erdem
Keyword(s):  
Infective Endocarditis ◽  
Central Nervous System Infection ◽  
Occipital Lobe ◽  
Neurological Complications ◽  
Blood Cultures ◽  
Rare Form ◽  
Presumptive Diagnosis ◽  
Parietal Lobes ◽  
Cranial Computerized Tomography ◽  
Infectious Disease Service

The group G streptococcal endocarditis is a rare form of infective endocarditis. In this form of infective endocarditis, serious neurological complications most commonly develop. We reported this case because of its being an unusual form of infective endocarditis that was caused by Group G Streptococcus. We also reviewed the literature. The patient was admitted to infectious disease service with a presumptive diagnosis of central nervous system infection. Blood cultures were positive for group G streptococcus. There was a mass on the posterior surface of the mitral valve which was 2x 2.5 cm in length on the echocardiography. In the cranial computerized tomography of our patient, slightly increased contrast media uptake was observed in the both parietal lobes, in the both frontal lobes, and in the anterior areas of right occipital lobe. Therefore, this case was assumed as infective endocarditis caused by group G streptococcus with multiple cerebral emboli. Ceftriaxone was given for 4 weeks and gentamicin was given for 2 weeks, and progressive improvement of the patient’s condition was seen.

Perforated giant mycotic aneurysm of mitral valve in a drug-addicted young man: Rare complication of infective endocarditis

2017 ◽  
Vol 35 (1) ◽  
pp. 129-131
Author(s):  
Vincenzo Lavanco ◽  
Mirko Curzi ◽  
Enrico Giustiniano ◽  
Donatella Raspante ◽  
Daniela Di Lisi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mycotic Aneurysm ◽  
Rare Complication

Can Infectious Endocarditis during Pregnancy Be Cured with Only Drug Treatment?

2015 ◽  
Vol 18 (1) ◽  
pp. 033
Author(s):  
Serhat Caliskan ◽  
Feyzullah Besli ◽  
Saim Sag ◽  
Fatih Gungoren ◽  
Ibrahim Baran
Keyword(s):  
Infective Endocarditis ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Prolapse ◽  
Treatment Options ◽  
Blood Cultures ◽  
Normal Vaginal Delivery ◽  
Posterior Leaflet ◽  
History Of ◽  
Current Guidelines

During pregnancy, infective endocarditis (IE) is quite rare but has a high mortality rate in terms of the mother and the fetus. In this article, a 24-year-old patient with a history of mitral valve prolapse (MVP) who was hospitalized due to IE and treated successfully is presented. On echocardiography, severe mitral valve prolapse, severe mitral regurgitation, and vegetation on the posterior leaflet of mitral valve were observed. Streptococcus mitis was subsequently isolated from four sets of blood cultures. The patient was diagnosed with IE. After 6 weeks of antibiotic therapy, the patient was cured completely without surgical treatment. At 40-weeks of pregnancy, the patient gave birth via a normal vaginal delivery. There were no problems with the 3,800-gram baby born. In current guidelines, there is very limited advice on treatment options for patients who develop IE during pregnancy. Therefore, evaluation of patient-based treatment options would be appropriate. In addition, IE prophylaxis for MVP is not recommended in current guidelines. However, in MVP patients with mitral regurgitation, prior to procedures associated with a high risk of infective endocarditis, IE prophylaxis may be rational.

scholarly journals Streptobacillus moniliformis mitral valve endocarditis and septic arthritis: the challenges of diagnosing rat-bite fever endocarditis

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Daisy Torres-Miranda ◽  
Madhi Moshgriz ◽  
Marc Siegel
Keyword(s):  
United States ◽  
Mitral Valve ◽  
Blood Culture ◽  
The United States ◽  
Blood Cultures ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Streptobacillus Moniliformis ◽  
Rat Bite Fever ◽  
Mitral Valve Vegetation

Streptobacillus moniliformis, the cause of rat-bite fever (RBF) in the United States, has rarely been reported as a cause of infectious endocarditis. In the majority of previously reported cases, the diagnosis was clinically based in patients with underlying valvular abnormalities in the setting of positive blood culture for Streptobacillus moniliformis. We report a case of native valve endocarditis secondary to Streptobacillus moniliformis in a woman with a mitral valve vegetation but negative blood cultures where the diagnosis was established using molecular diagnostics on the valvular tissue.

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