[Non-bacterial thrombotic endocarditis. Report of one case]

Area of Science:

• Cardiology
• Oncology
• Neurology

Background:

• Nonbacterial thrombotic endocarditis (NTE) involves sterile vegetations on heart valves, often linked to malignancy or chronic inflammation.
• Distinguishing NTE from infective endocarditis, especially with negative blood cultures, poses a clinical challenge.

Observation:

• A 49-year-old female presented with weight loss, asthenia, fever, and multiple cerebrovascular attacks.
• Negative blood cultures and persistent fever unresponsive to antibiotics suggested a non-infectious etiology.
• Transesophageal echocardiography revealed mitral valve vegetations and leaflet thickening.

Findings:

• Pancreatic cancer with distant metastases was identified as the underlying cause.
• The clinical presentation strongly supported a diagnosis of nonbacterial thrombotic endocarditis secondary to malignancy.

Implications:

• This case underscores the importance of considering malignancy in patients with suspected endocarditis and negative cultures.
• Early recognition of NTE in the context of cancer is crucial for appropriate management and patient outcomes.
• Further research into the mechanisms linking cancer and thrombotic events in endocarditis is warranted.