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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Splenic rupture as a presenting feature of endocarditis
James Roger Winearls1, Steven McGloughlin, John F Fraser
1Critical Care Research Group, Adult Intensive Care Unit, The Prince Charles Hospital, Chermside, Queensland, 4032, Australia.
Summary
This case report details the first instance of infective endocarditis causing spontaneous splenic rupture. It emphasizes considering endocarditis in patients with splenic rupture, especially intravenous drug users.
Area of Science:
- Cardiology
- Infectious Diseases
- Abdominal Surgery
Background:
- Infective endocarditis (IE) is a serious infection of the heart valves.
- Spontaneous splenic rupture is a rare but life-threatening condition.
- Intravenous drug use is a known risk factor for infective endocarditis.
Observation:
- A patient with a history of intravenous drug use presented with hypovolemic shock due to spontaneous splenic rupture.
- Following emergency splenectomy, the patient was diagnosed with mitral valve infective endocarditis.
- Enterococcus faecalis was identified as the causative agent in blood, splenic, and mitral valve cultures.
Findings:
- This is the first reported case of enterococcal endocarditis presenting with spontaneous splenic rupture.
- Successful mitral valve replacement was performed, and the patient recovered.
Implications:
- Clinicians should consider infective endocarditis in cases of spontaneous splenic rupture, particularly in high-risk individuals like intravenous drug users.
- Early diagnosis and treatment are crucial for favorable outcomes in such complex presentations.
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