Vascular Complications of Infective Endocarditis: Diagnosis and Management

Ibtisam, Kissami; Bekkaoui, Mehdi El; Skiker, Imane; Bentata, Y.; Ismaili, Nabila; Elouafi, Noha

doi:10.7759/cureus.14678

Cited by 1 publication

(1 citation statement)

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“…When IE presents acutely, it is a life-threatening and complex medical emergency that is inevitably fatal without prompt treatment with broad-spectrum antimicrobials [ 4 ] in addition to early integral surgical correction of the abnormal excrescence appearing on heart valves [ 5 ]. Delayed treatment and management complicate the clinical course and may result in extra-cardiac embolization, which has been reported to occur in a quarter of patients with IE [ 6 , 7 ]. The spectrum of clinical manifestations in IE includes the eruption of non-tender hemorrhagic macular purpuric lesions over most distal peripheral sites of the hands and feet, including the appearance of hemorrhage streaks underneath the nails, which result from a vascular phenomenon that transpires in IE.…”

Section: Introductionmentioning

confidence: 99%

A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives

et al. 2023

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Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.

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Section: Introductionmentioning

confidence: 99%