A dairy worker with fever and an abnormal echocardiogram

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• A 38-year-old male presented with progressive dyspnea, fever, malaise, and weight loss.
• He had a history of working in the dairy industry in the Middle East.

Purpose of the Study:

• To identify the abnormal cardiac structure visualized on echocardiography in a patient with suspected infective endocarditis.

Main Methods:

• Clinical presentation and physical examination findings were documented.
• Two-dimensional transthoracic and transesophageal echocardiography were performed.
• Blood cultures were obtained, and laboratory tests were conducted.

Main Results:

• Echocardiography showed thickened bicuspid aortic valve cusps with moderate eccentric aortic regurgitation.
• An abnormal structure, identified as an aortic root abscess with a vegetation, was observed posterior to the left ventricular outflow tract and aorta.
• Blood cultures were sterile, and renal and liver function tests were normal.

Conclusions:

• The findings indicate an aortic root abscess secondary to infective endocarditis on a bicuspid aortic valve.
• The patient was initiated on antibiotics and heart failure management and referred for surgical intervention.