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Related Experiment Videos

[Diagnostic problems in a patient with staphylococcal endocarditis].

J R Mogilski1

  • 1Oddziału Chorób Wewnetrznych Specjalistycznego Zespołu Chorób Płuc i Gruźlicy w Bystrej Sl.

Wiadomosci Lekarskie (Warsaw, Poland : 1960)
|October 20, 2001
PubMed
Summary

A 68-year-old patient with a history of aortic valve graft and CABG died from Staphylococcus aureus endocarditis. Early broad-spectrum antibiotics may improve outcomes in post-cardiac surgery fever patients.

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[Hepatic abscess treated conservatively].

Wiadomosci lekarskie (Warsaw, Poland : 1960)·2002
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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Pathology

Background:

  • A 68-year-old male with a history of aortic valve graft and coronary artery bypass grafting (CABG) presented with recurrent fever and syncope.
  • Initial presentation suggested a urinary tract infection (UTI), treated with quinolones, with temporary fever abatement.

Observation:

  • Recurrent fever after two weeks prompted further investigation.
  • Diagnosis of bacterial endocarditis was suspected, and broad-spectrum antibiotics were initiated despite negative blood cultures.
  • The patient developed circulatory failure and cachexia, leading to death within two weeks.

Findings:

  • Blood cultures eventually yielded Staphylococcus aureus.
  • Autopsy revealed phlegmonic, hemorrhagic changes, and necrosis around the artificial aortic valve graft.
  • Microscopic examination showed interstitial microfocal phlegmonic foci.

Implications:

  • This case highlights the critical importance of considering bacterial endocarditis in patients with fever post-cardiac surgery.
  • Prompt initiation of broad-spectrum antibiotics, even with initially negative blood cultures, may be crucial for successful treatment.
  • Delayed or inadequate antibiotic therapy can lead to severe complications and mortality in prosthetic valve endocarditis.

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