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Multivalve endocarditis with multiple peripheral and pulmonary embolisms: a case report

Anabela Pinto1, Luísa Moura Branco, Nuno Pelicano

  • 1Serviço de Cardiologia do Hospital de Santa Marta, Lisboa, Portugal. yarispiupiu@iol.pt

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|October 26, 2005
PubMed

Insights

Diagnosing infective endocarditis in elderly patients is challenging. This case highlights the importance of considering this infection, even with atypical presentations like peripheral embolism and mycotic aneurysms.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Geriatrics

Background:

  • Fever of unknown origin (FUO) presents diagnostic challenges in the elderly.
  • Infective endocarditis is frequently overlooked in older patients, with other conditions like cancer often prioritized.
  • Subacute infective endocarditis requires careful consideration in geriatric populations presenting with FUO.

Observation:

  • An elderly woman presented with FUO and was initially suspected of having malignancy.
  • The patient experienced multiple pulmonary and peripheral embolic events.
  • A left femoral mycotic aneurysm was identified during the diagnostic workup.

Findings:

  • The patient was diagnosed with subacute mitral and tricuspid infective endocarditis.
  • Peripheral embolism was a key indicator leading to the correct diagnosis.
  • The presence of a mycotic aneurysm complicated the clinical picture.

Implications:

  • This case underscores the need for a high index of suspicion for infective endocarditis in elderly patients with FUO.
  • Peripheral and pulmonary embolisms can be critical signs of endocarditis in this demographic.
  • Timely diagnosis and treatment of infective endocarditis are crucial to prevent severe complications such as mycotic aneurysms.

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