Limits...
A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review.

Khan S, Smyrlis A, Yaranov D, Oelberg D, Jimenez E - Case Rep Cardiol (2015)

Bottom Line: If left untreated, IE is generally fatal.Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena.We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse.

View Article: PubMed Central - PubMed

Affiliation: Danbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USA.

ABSTRACT
Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.

No MeSH data available.


Related in: MedlinePlus

Electrocardiogram. Day 1 ECG on left and day 2 on right. Day 1 ECG reveals probable sinus tachycardia with first-degree heart block at 111 bpm. Day 2 ECG shows complete heart block with a ventricular rate of 67 bpm.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4469760&req=5

fig2: Electrocardiogram. Day 1 ECG on left and day 2 on right. Day 1 ECG reveals probable sinus tachycardia with first-degree heart block at 111 bpm. Day 2 ECG shows complete heart block with a ventricular rate of 67 bpm.

Mentions: Blood cultures from the previous hospital grew MSSA. Repeat bacterial and fungal cultures at our institution came back negative. Initial ECG showed probable sinus tachycardia with first-degree atrioventricular block (Figure 2). Transesophageal echocardiogram (TEE) demonstrated a bicuspid aortic valve with multiple mobile echo densities along both the anterior and posterior leaflets with the largest one measuring 1.8 cm (Figure 3).


A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review.

Khan S, Smyrlis A, Yaranov D, Oelberg D, Jimenez E - Case Rep Cardiol (2015)

Electrocardiogram. Day 1 ECG on left and day 2 on right. Day 1 ECG reveals probable sinus tachycardia with first-degree heart block at 111 bpm. Day 2 ECG shows complete heart block with a ventricular rate of 67 bpm.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4469760&req=5

fig2: Electrocardiogram. Day 1 ECG on left and day 2 on right. Day 1 ECG reveals probable sinus tachycardia with first-degree heart block at 111 bpm. Day 2 ECG shows complete heart block with a ventricular rate of 67 bpm.
Mentions: Blood cultures from the previous hospital grew MSSA. Repeat bacterial and fungal cultures at our institution came back negative. Initial ECG showed probable sinus tachycardia with first-degree atrioventricular block (Figure 2). Transesophageal echocardiogram (TEE) demonstrated a bicuspid aortic valve with multiple mobile echo densities along both the anterior and posterior leaflets with the largest one measuring 1.8 cm (Figure 3).

Bottom Line: If left untreated, IE is generally fatal.Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena.We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse.

View Article: PubMed Central - PubMed

Affiliation: Danbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USA.

ABSTRACT
Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.

No MeSH data available.


Related in: MedlinePlus