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Cerebral hemorrhage in infective endocarditis caused by Actinobacillus actinomycetemcomitans

Gen-Min Lin1, Kai-Min Chu, Chun-Jung Juan

  • 1Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

The American Journal of the Medical Sciences
|November 16, 2007
PubMed

Insights

Rare cerebral hemorrhage in endocarditis caused by Actinobacillus actinomycetemcomitans was observed. This case highlights the importance of considering rare complications in prosthetic valve endocarditis.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Cardiology

Background:

  • Prosthetic valve endocarditis (PVE) is a serious complication requiring prompt diagnosis and treatment.
  • Actinobacillus actinomycetemcomitans is a rare cause of infective endocarditis, particularly in patients with prosthetic valves.

Observation:

  • A 51-year-old male with a prosthetic mitral valve on warfarin presented with fever and a cardiac murmur.
  • Initial echocardiography was negative for vegetations; however, blood cultures and transesophageal echocardiography later identified a small filament on the mitral prosthetic ring.
  • The patient developed acute neurological deficits, with brain MRI revealing a right parietal-occipital lobe hematoma.

Findings:

  • Blood cultures eventually identified Actinobacillus actinomycetemcomitans.
  • The patient was treated with cefepime and ceftriaxone, with dosage adjustments made after the neurological event.
  • Recovery was achieved with resolution of cerebral lesions on CT scans.

Implications:

  • This case underscores the rare but serious neurological complications, such as cerebral hemorrhage, that can arise from Actinobacillus actinomycetemcomitans endocarditis.
  • Prompt identification and appropriate antibiotic therapy are crucial for managing PVE and its complications.
  • Further research into the specific risk factors and management strategies for Actinobacillus actinomycetemcomitans PVE is warranted.

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