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Neisseria sicca Endocarditis Presenting as Multiple Embolic Brain Infarcts
Christine Kirlew1, Kobina Wilmot2, Jorge L Salinas3
1Department of Internal Medicine.
Open Forum Infectious Diseases
|August 19, 2015
Summary
A rare brain infection caused by Neisseria sicca endocarditis led to strokes and behavioral changes in a patient with a history of heart valve replacement. Prompt diagnosis is crucial for managing this uncommon cause of neurological events.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiology
Background:
- A 58-year-old male with a history of human immunodeficiency virus infection, ischemic cardiomyopathy, and a prosthetic mitral valve presented with neurological decline.
- The patient exhibited a 14-day history of progressive forgetfulness and aggressiveness, alongside a supra-therapeutic international normalized ratio.
Purpose of the Study:
- To report a rare case of Neisseria sicca endocarditis presenting with neurological complications.
- To highlight the diagnostic challenges and clinical implications of infective endocarditis in patients with prosthetic heart valves.
Main Methods:
- Clinical presentation and patient history review.
- Neuroimaging via non-contrast computed tomography of the brain.
- Identification of the causative agent through microbiological investigation.
Main Results:
- Brain imaging revealed multiple infarcts with hemorrhagic conversion.
- The underlying cause was identified as Neisseria sicca endocarditis, a rare etiology for such neurological events.
- The patient's supra-therapeutic international normalized ratio indicated potential complications related to anticoagulation management.
Conclusions:
- Neisseria sicca endocarditis can present with severe neurological manifestations, including stroke.
- This case underscores the importance of considering infective endocarditis in patients with prosthetic valves and unexplained neurological symptoms.
- Early diagnosis and appropriate management are critical for improving outcomes in patients with endocarditis-related neurological complications.
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