Complicated infective endocarditis: a case series

J Med Case Rep. 2017 May 8;11(1):128. doi: 10.1186/s13256-017-1274-7.

Abstract

Background: Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm.

Case presentation: We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess. One case of a patient with prosthetic valve endocarditis was complicated by intracerebral hemorrhage caused by mycotic aneurysm rupture. A second case of a patient with right-sided valve endocarditis associated with a central catheter was complicated by an abdominal aortic mycotic aneurysm. The third patient had a splenic infarction and abscess associated with infected cardiac thrombi.

Conclusions: Complicated infective endocarditis is rare and is associated with cardiac, neurologic, renal, musculoskeletal, and systemic complications related to infection, such as embolization, metastatic infection, and mycotic aneurysm. Infective endocarditis caused by Staphylococcus aureus is more frequently associated with complications. Because the mortality rate increases when complications develop, aggressive antibiotic therapy and surgery, combined with specific treatments for the complications, are necessary.

Keywords: Complications; Infective endocarditis; Mycotic aneurysm.

Publication types

  • Case Reports

MeSH terms

  • Abscess / complications*
  • Aged
  • Aneurysm, Infected / complications*
  • Aneurysm, Infected / diagnostic imaging
  • Aneurysm, Infected / surgery
  • Aortic Aneurysm, Abdominal / complications*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Brain / diagnostic imaging
  • Catheterization, Peripheral / adverse effects
  • Echocardiography
  • Endocarditis / complications*
  • Endocarditis / microbiology
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Splenic Diseases / complications*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / isolation & purification
  • Tomography, X-Ray Computed
  • Tricuspid Valve / diagnostic imaging