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[Infective endocarditis with splenic abscess and cerebral hemorrhage]
Masanobu Yamauchi1, K Imai, T Sasaki
1Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 12, 2005
Summary
This case study highlights a patient with fever and neurological symptoms, ultimately diagnosed with infective endocarditis complicated by splenic abscesses. Surgical intervention, including splenectomy and mitral valve repair, led to a successful outcome.
Area of Science:
- Cardiology
- Infectious Diseases
- Neurosurgery
Background:
- Infective endocarditis (IE) can present with diverse systemic complications.
- Cerebral hemorrhages and splenic abscesses are rare but serious manifestations of IE.
Observation:
- A 65-year-old male presented with ataxic gait, fever, and neurological deficits.
- Brain MRI revealed multiple cerebral hemorrhages; echocardiogram showed mitral valve vegetations and regurgitation.
- Blood cultures were negative, but CT scan identified splenic abscesses despite antibiotic treatment.
Findings:
- Splenic pathology confirmed septic emboli as the cause of abscesses.
- The patient underwent successful splenectomy followed by mitral valve repair and maze operation.
- The patient experienced an uneventful postoperative recovery.
Implications:
- This case underscores the importance of considering IE in patients with unexplained fever and neurological or systemic complications.
- Aggressive management, including surgical intervention for splenic abscesses and valve repair, can be life-saving.
- Negative blood cultures do not exclude IE, necessitating a comprehensive diagnostic approach.