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[Staphylococcus aureus endocarditis in a puerperal woman with mitral and tricuspid valve prolapse]
M de B Pereira1, S Timerman, A Timerman
1Hospital Israelita Albert Einstein, São Paulo.
Insights
A young woman experienced severe puerperal sepsis and septic emboli due to Staphylococcus aureus. Prompt medical intervention, including surgery and valve replacement, was crucial for her survival.
Area of Science:
- Cardiology
- Infectious Diseases
- Obstetrics
Background:
- A 17-year-old woman with pre-existing mitral and tricuspid valve prolapse and myxomatous degeneration.
- Presented with puerperal infection by Staphylococcus aureus, leading to sepsis.
Observation:
- Multiple septic emboli affected the right eye, left thumb, spleen, and left calf.
- Developed temporary atrioventricular block requiring external pacing.
- Diagnosed with acute endocarditis and acute mitral regurgitation, necessitating valve replacement.
Findings:
- Underwent total hysterectomy and right eye enucleation.
- Experienced a second episode of endocarditis causing moderate tricuspid valve regurgitation.
- Completed antibiotic therapy and was discharged on day 62.
Implications:
- Highlights the severe complications of puerperal sepsis, including endocarditis and septic emboli.
- Underscores the importance of timely surgical and medical interventions in managing complex obstetric infections.
- Demonstrates the potential for significant cardiovascular compromise in postpartum sepsis.
Abstract:
A 17-year-old woman with mitral and tricuspid valve prolapse and myxomatous degeneration presented puerperal infection by Staphylococcus aureus with clinical picture of sepsis and multiple septic embolism (right eye, left thumb, spleen, and left calf). She underwent total hysterectomy on the 10th day postdelivery and right eye enucleation on the 16th. Temporary total AV block occurred on the 14th day with temporary external pacing during the next couple of days. Acute endocarditis with acute mitral regurgitation was diagnosed on the 13th day, demanding immediate valve replacement. On the 46th day she developed moderate tricuspid valve regurgitation due to another episode of endocarditis. Final clinical discharge took place on the 62nd day after antibiotic therapy completion.