Infective endocarditis: a consumptive disease among the elderly

Area of Science:

• Cardiology
• Infectious Diseases
• Geriatrics

Background:

• Infective endocarditis (IE) diagnosis in elderly patients presents unique challenges due to atypical presentations.
• Subacute IE often has an indolent course, with slow development of cardiac lesions.
• Anemia and weight loss can be prominent symptoms, potentially masking the true diagnosis.

Observation:

• A case of an elderly patient with degenerative mitral valve disease is presented.
• The patient developed bacterial endocarditis caused by Streptococcus mitis.
• Clinical presentation included significant weight loss and absence of fever, leading to diagnostic delays.

Findings:

• The patient's endocarditis was not treated due to a delayed diagnosis.
• Autopsy revealed mitral valve and left atrium impairment from endocarditis.
• Lung involvement was noted, potentially linked to biomass fuel smoke inhalation.

Implications:

• Highlights the importance of considering IE in elderly patients with non-specific symptoms like weight loss and no fever.
• Emphasizes the need for timely diagnostic evaluation to prevent severe outcomes.
• Suggests potential environmental factors, such as biomass smoke, may influence respiratory health in conjunction with IE.