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Infectious endocarditis presenting as intracranial hemorrhage in a patient admitted for lumbar radiculopathy

David Ethan Kahn1, Kristine O'Phelan1, Ross Bullock2

  • 1Miller School of Medicine University of Miami, Department of Neurology, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136, USA.

Case Reports in Critical Care
|May 15, 2014
PubMed

Insights

Bacterial endocarditis can cause brain hemorrhage, often due to mycotic aneurysms. Prompt diagnosis via imaging and cultures is crucial for identifying this rare but serious complication.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiology

Background:

  • Infectious endocarditis is a known complication in neurologic intensive care units.
  • Intracranial hemorrhage is a rare but serious manifestation of infectious endocarditis.

Observation:

  • A patient admitted for lumbar radiculopathy developed a large intraparenchymal hemorrhage.
  • The patient was retrospectively diagnosed with bacterial endocarditis.

Findings:

  • Positive hematoma cultures and transesophageal echocardiogram vegetation confirmed bacterial endocarditis.
  • Further evaluation revealed an underlying mycotic aneurysm as the cause of hemorrhage.

Implications:

  • This case highlights the importance of considering infectious endocarditis in patients with unexplained intracranial hemorrhage.
  • Diagnostic imaging and microbiological investigations are essential for identifying structural lesions like mycotic aneurysms.
  • Early recognition and treatment of bacterial endocarditis can prevent severe neurological outcomes.

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