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Cerebral Aneurysm from Cardiobacterium hominis Endocarditis

Aaron Glucksman, Edgar Naut

    Connecticut Medicine
    |June 23, 2016
    PubMed

    Insights

    A patient with a history of heart valve surgery developed vertigo due to a cerebellar stroke and a brain aneurysm. Cardiobacterium hominis infection was identified on the prosthetic aortic valve.

    Area of Science:

    • Cardiology
    • Neurology
    • Infectious Disease

    Background:

    • Bioprosthetic aortic valve replacement and tricuspid valve annuloplasty are complex cardiac procedures.
    • Cerebrovascular events can manifest with diverse neurological symptoms such as vertigo.
    • Mycotic aneurysms represent a serious complication of infective endocarditis.

    Observation:

    • A 43-year-old male presented with vertigo.
    • Imaging revealed an acute infarct in the left superior cerebellum and a left-middle cerebral artery mycotic aneurysm.
    • Transthoracic echocardiogram showed vegetation on the bioprosthetic aortic valve.

    Findings:

    • Blood cultures confirmed the presence of Cardiobacterium hominis.
    • The patient's symptoms were attributed to a combination of cerebellar infarction and a mycotic aneurysm.
    • Infective endocarditis involving the prosthetic valve was diagnosed.

    Implications:

    • This case highlights the importance of considering infective endocarditis in patients with prosthetic valves presenting with neurological deficits.
    • Prompt diagnosis and treatment of Cardiobacterium hominis endocarditis are crucial to prevent severe complications like stroke and aneurysm rupture.
    • Multidisciplinary management involving cardiology, neurology, and infectious disease specialists is essential for optimal patient outcomes.

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