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Listeria endocarditis with acute thoracoabdominal aortic dissection.
Keisuke Kida1, Naohiko Osada, Kenji Isahaya
1Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki. heart-kida@marianna-u.ac.jp
Internal Medicine (Tokyo, Japan)
|August 7, 2007
Summary
A 71-year-old male developed infective endocarditis due to Listeria monocytogenes. He later developed acute thoracoabdominal aortic dissection, a serious complication, but recovered and was discharged.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- The patient, a 71-year-old male with a history of hypertension, aortic regurgitation, and alcoholic hepatitis, presented with fever and anorexia.
- He was undergoing treatment for multiple conditions, including dental issues.
Observation:
- Blood cultures identified Listeria monocytogenes, and echocardiography revealed mitral valve vegetation, leading to a diagnosis of infective endocarditis.
- Initial treatment with penicillin improved fever and inflammatory markers.
Findings:
- Despite initial improvement, the patient developed recurrent fever on the 24th hospital day.
- A computed tomography (CT) scan revealed a type IIIb acute thoracoabdominal aortic dissection, not present on admission.
- Antihypertensive agents were administered to manage blood pressure.
Implications:
- This case highlights the potential for serious cardiovascular complications, such as aortic dissection, in patients with infective endocarditis.
- Prompt diagnosis and management of both endocarditis and aortic dissection are crucial for patient outcomes.
- The successful management underscores the importance of multidisciplinary care in complex cases involving infectious and cardiovascular emergencies.
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