Acute valvular obstruction from streptococcal endocarditis

Culture‐Negative Suppurative Endocarditis Causing Severe Mitral Valve Obstruction: Complementary Use of Transesophageal and Transthoracic Echocardiography

“…Mitral valve obstruction is a rare complication of infective endocarditis.The first case from autopsy material was reported by Roberts et al 5 in 1967. Including the present report, there have been 22 cases of this condition reported in the literature 5–16 . A review of these reports reveal that 12 of total 22 patients had evidence of rheumatic mitral valve disease and 5 patients had no known previous valvular disease but had identified causes for bacteremia, while the remaining 5 patients had neither identifiable valvular disease nor a cause for bacteremia (Table I).…”

“…Fifteen of 22 patients presented with acute pulmonary congestion and 8 of 22 patients with severe hypotension or shock. The clinical course progresses more rapidly in patients infected by S.aureus 6 , 14 or S.fecalis 16 …”

Aortic valve endocarditis caused bySalmonella species

“…Disruption of an aortic valve cusp causing it to become flail may lead to severe aortic regurgitation and decompensated left ventricular failure. 14 The causative pathogen in this case, Salmonella species, is uncommonly responsible for endocarditis. Cohen and coworkers, reviewing the literature over 32 years, 18 found 25 cases of endocarditis caused by Salmonella species.…”

“…Similar findings have been previously demonstrated. [12][13][14] Color Doppler study showed moderate aortic regurgitation. Fistula-type communications between the ascending aorta and the right ventricle, found at surgery in our patient, have previously been described in patients with endocarditis.…”

“…12 Several studies have reported significantly higher rates of detection of anatomically confirmed vegetations, abscesses, and fistulas by TEE than by TTE. 5,11,[13][14][15] The degree and time course of valvular damage due to endocarditis largely depend on the nature of the infecting organism. Disruption of an aortic valve cusp causing it to become flail may lead to severe aortic regurgitation and decompensated left ventricular failure.…”