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Haemophilus parainfluenzae endocarditis with systemic embolisation following maxillary sinusitis
Margarida Barreto Cortes1, Vitor Teixeira2, Samuel Raimundo Fernandes3
1Serviço de Medicina Interna, Hospital de Santa Maria, Lisbon, Portugal.
BMJ Case Reports
|September 8, 2016
Summary
Haemophilus parainfluenzae endocarditis can rapidly cause severe mitral valve damage and central nervous system embolisation. This case shows significant structural valve deterioration can occur quickly, even with effective antibiotic treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Neurology
Background:
- Haemophilus parainfluenzae is a rare cause of infective endocarditis.
- Central nervous system complications are a known, but infrequent, presentation of endocarditis.
Observation:
- A patient presented with symptoms suggestive of endocarditis.
- Initial echocardiograms (transoesophageal and transthoracic) showed no evidence of endocarditis.
- The patient rapidly developed large mitral valve vegetations and subsequent valve rupture.
Findings:
- Despite prompt and appropriate antibiotic therapy, the patient experienced rapid progression of valvular damage.
- Embolisation to the central nervous system occurred, indicating the severity of the infective process.
Implications:
- This case underscores the potential for swift and severe structural valve damage in infective endocarditis, even with a positive clinical response to antibiotics.
- It highlights the importance of vigilant monitoring and early surgical intervention in cases of suspected endocarditis with rapid progression.
- Haemophilus parainfluenzae should be considered in the differential diagnosis of culture-negative or atypical endocarditis, especially with neurological complications.
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