Infective endocarditis developing serious multiple complications

BMJ Case Rep. 2013 Jan 28:2013:bcr2012008097. doi: 10.1136/bcr-2012-008097.

Abstract

A 20-year-old female patient with no history of heart disease presented to the hospital with high fever, cough and sputum. On the third day of hospitalisation, left facial paralysis developed and cranial revealed an infarct in the right frontoparietotemporal lobe. Transthoracic echocardiography revealed 1.5 × 2 cm-sized vegetation on the mitral valve and severe mitral regurgitation. On the 11th day of hospitalisation, multiple emboli were shown to be present in the left iliac artery. Since the patient had recurrent septic emboli despite 3 weeks of treatment, a surgical intervention was planned. The vegetation was removed and the mitral valve was replaced by mechanical prostheses. During the postoperative period, acute renal failure developed in the patient. The treatment was completed in 6 weeks with full recovery. This case confirms that infective endocarditis may present with various clinical situations, and that a high index of suspicion and surgical intervention, in addition to aggressive antibiotic therapy, is lifesaving.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology
  • Diagnosis, Differential
  • Echocardiography
  • Embolism / etiology
  • Endocarditis / complications*
  • Endocarditis / diagnosis
  • Endocarditis / diagnostic imaging
  • Female
  • Humans
  • Iliac Artery
  • Mitral Valve Insufficiency / etiology
  • Mitral Valve Insufficiency / surgery
  • Young Adult