Related Experiment Video

Updated: Jul 1, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Infective endocarditis of native valve after anterior nasal packing

Suriya Jayawardena1, Jacob Eisdorfer, Shalaka Indulkar

  • 1Department of Medicine, Coney Island Hospital, Maimonides Medical Center, Brooklyn, NY 11235, USA. suriyakbrsj@yahoo.com

American Journal of Therapeutics
|September 22, 2006
PubMed

Insights

This case report highlights a rare instance of bacterial endocarditis following anterior nasal packing. Methicillin-resistant Staphylococcus aureus (MRSA) infection developed despite prophylactic antibiotics, underscoring potential risks.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Otolaryngology

Background:

  • Anterior nasal packing is a common treatment for epistaxis.
  • Current guidelines do not recommend endocarditis prophylaxis for native heart valves during anterior nasal packing.
  • Toxic shock syndrome is a known complication of nasal packing.

Observation:

  • A patient developed fever and hypotension three days after anterior nasal packing with antibiotic-infused gauze.
  • Blood cultures revealed methicillin-resistant Staphylococcus aureus (MRSA).
  • Transesophageal echocardiography identified vegetation on the mitral valve, confirming bacterial endocarditis.

Findings:

  • This case represents the first reported instance of native valve bacterial endocarditis secondary to anterior nasal packing.
  • The infection was attributed to MRSA originating from the nasal packing.
  • Prophylactic oral clindamycin did not prevent the development of endocarditis.

Implications:

  • This case suggests a potential, albeit rare, risk of bacterial endocarditis following anterior nasal packing, even with prophylactic measures.
  • It may prompt a re-evaluation of prophylaxis strategies for specific patient populations.
  • Further research is needed to understand the mechanisms and incidence of this complication.

More Related Videos

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues07:50

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues

Published on: January 7, 2019

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

Related Concept Videos

Epistaxis01:30

Epistaxis

Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Endocarditis I: Introduction01:25

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...