[Infectious endocarditis associated with multiple mycotic aneurysms; report of a case]

Area of Science:

• Cardiology
• Neurosurgery
• Infectious Diseases

Background:

• Infectious endocarditis (IE) is a serious infection that can lead to severe complications.
• Mycotic aneurysms are a rare but life-threatening complication of IE, often requiring complex management.
• This case involves a 68-year-old male with IE of the mitral valve complicated by aneurysms in the middle cerebral artery (MCA) and superior mesenteric artery (SMA).

Observation:

• The patient presented with IE and concurrent mycotic aneurysms in the MCA and SMA.
• Initial management included coil embolization of the SMA aneurysm and surgical treatment of the MCA aneurysm.
• Antibiotic therapy for Enterococcus faecalis infection was administered throughout the treatment period.

Findings:

• Successful management of both MCA and SMA mycotic aneurysms was achieved through a combination of endovascular and surgical interventions.
• Mitral valve repair was successfully performed after controlling the IE, utilizing a flip-over technique for leaflet defect closure.
• The patient's IE was effectively controlled with targeted antibiotic therapy.

Implications:

• This case highlights the importance of a tailored, multidisciplinary approach for managing IE with multiple mycotic aneurysms.
• The successful valve repair demonstrates the feasibility of reconstructive surgery in complex IE cases.
• Further research and consensus are needed on the optimal treatment strategies for IE-associated mycotic aneurysms.