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Chronic Otitis Media Resulting in Aortic Valve Replacement: A Case Report.

Guler A, Sahin MA, Gurkan Yesil F, Yildizoglu U, Demirkol S, Arslan M - J Tehran Heart Cent (2015)

Bottom Line: His body temperature was 38 (°)C.There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency.He was discharged on the 16(th) postoperative day in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey.

ABSTRACT
The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 (°)C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16(th) postoperative day in good condition.

No MeSH data available.


Related in: MedlinePlus

Left ear: presence of chronic otitis media: A) central perforation of the tympanic membrane; B) mucoid discharge; and C) two tympanosclerotic plaques
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Figure 1: Left ear: presence of chronic otitis media: A) central perforation of the tympanic membrane; B) mucoid discharge; and C) two tympanosclerotic plaques

Mentions: The patient was referred to the cardiology department for further evaluation of the diastolic murmur and dyspnea. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography (TEE) showed a BAV as well as a flail lesion extending to the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. At first, this unusual lesion was considered to be a vegetation. However, three-dimensional TEE zoom images demonstrated this flailed tissue as a part of the left-right coronary cusp with a defect in the middle part, due to IE. An empiric antibiotic regimen was initiated with Vancomycin and Gentamicin, and a blood sample was taken to adjust the appropriate antibiotic treatment according to the antibiogram. No acute lung edema and acute cardiac failure were diagnosed. For elective surgery, the patient was transferred to our cardiovascular surgery department. After 3 days, the result of the blood culture test was interesting: Alloiococcus otitidis, a Gram-positive coccus as a rare pathogen for IE. Subsequently, he was reevaluated for otitis and the results revealed that there had been COM with intermittent exudative odorless ear discharge for many years since his childhood. He was referred to the otorhinolaryngology department, where a perforated left tympanic membrane with mucoid discharge was detected in the patient (Figure1) and an additional antibiotic drop treatment of local ciprofloxacin was prescribed.


Chronic Otitis Media Resulting in Aortic Valve Replacement: A Case Report.

Guler A, Sahin MA, Gurkan Yesil F, Yildizoglu U, Demirkol S, Arslan M - J Tehran Heart Cent (2015)

Left ear: presence of chronic otitis media: A) central perforation of the tympanic membrane; B) mucoid discharge; and C) two tympanosclerotic plaques
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4477094&req=5

Figure 1: Left ear: presence of chronic otitis media: A) central perforation of the tympanic membrane; B) mucoid discharge; and C) two tympanosclerotic plaques
Mentions: The patient was referred to the cardiology department for further evaluation of the diastolic murmur and dyspnea. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography (TEE) showed a BAV as well as a flail lesion extending to the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. At first, this unusual lesion was considered to be a vegetation. However, three-dimensional TEE zoom images demonstrated this flailed tissue as a part of the left-right coronary cusp with a defect in the middle part, due to IE. An empiric antibiotic regimen was initiated with Vancomycin and Gentamicin, and a blood sample was taken to adjust the appropriate antibiotic treatment according to the antibiogram. No acute lung edema and acute cardiac failure were diagnosed. For elective surgery, the patient was transferred to our cardiovascular surgery department. After 3 days, the result of the blood culture test was interesting: Alloiococcus otitidis, a Gram-positive coccus as a rare pathogen for IE. Subsequently, he was reevaluated for otitis and the results revealed that there had been COM with intermittent exudative odorless ear discharge for many years since his childhood. He was referred to the otorhinolaryngology department, where a perforated left tympanic membrane with mucoid discharge was detected in the patient (Figure1) and an additional antibiotic drop treatment of local ciprofloxacin was prescribed.

Bottom Line: His body temperature was 38 (°)C.There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency.He was discharged on the 16(th) postoperative day in good condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Gulhane School of Medicine, Ankara, Turkey.

ABSTRACT
The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 (°)C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16(th) postoperative day in good condition.

No MeSH data available.


Related in: MedlinePlus