Septic embolic encephalitis after Staphylococcus aureus endocarditis of a prosthetic valve in a 57-year-old woman: a case report

Abstract

For prosthetic heart valves the risk of infection is much higher than for native heart valves. During the course of infective endocarditis 20-40% of all patients suffer from cerebrovascular complications such as ischaemic stroke or intracerebral haemorrhage. We present the case of a 57-year-old woman who had undergone surgery to mechanically replace an aortic heart valve 11 months ago and suffered from repeated ischaemic strokes with secondary haemorrhage. The initial antibiotic regimen was ineffective in treating the later diagnosed Staphylococcus aureus infection of the prosthetic valve. Escalation of the antibiotic treatment was not able to halt the clinical course that finally led to the patient’s death. The case report emphasizes the importance of early identification of the aetiology of infection in patients with mechanical heart valve replacement. Without rapid and adequate treatment there is a considerable risk for the development of severe neurological sequelae and cardiac failure that can ultimately result in a fatal course of this clinical picture.

Astroglia in Sepsis Associated Encephalopathy

“…In this regard, the signal example can be septic endocarditis characterized by microbial emboli entering the brain parenchyma and causing ischemic infarction foci in conjunction with formation of abscesses. However, at present, this form of brain lesion is classified as septicembolic encephalitis [27]. Also there are other indications for direct brain microbe invasion with formation of microabscesses in human SAE [28,29].…”

Septic Embolic Encephalitis Following Cardiac Valve Replacement

“…Septic embolic encephalitis stands as a rare and potentially life-threatening complication that may manifest subsequent to cardiac valve replacement procedures [1]. The risk of prosthetic valve infection significantly exceeds that of native valves, with an approximate incidence of 1% at 12 months and 3% at 60 months following surgery [2]. The migration of infected emboli originating from the prosthetic valve can instigate embolic infarcts in various organs, including the brain.…”