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Infective endocarditis related to acute cholecystitis
L A Bortolotto1, A J Mansur, M Grinberg
1Heart Institute, Sao Paulo University Medical School, Brazil.
The Thoracic and Cardiovascular Surgeon
|August 1, 1988
Summary
A patient with a dura-mater valve prosthesis developed infective endocarditis due to gallbladder inflammation. Despite valve replacement, persistent infection led to a fatal outcome, highlighting the importance of treating the source of infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Gastroenterology
Background:
- Infective endocarditis is a serious infection of the heart valves.
- Gallbladder disease, such as chronic cholelithiasis and acute cholecystitis, can be a source of systemic infection.
- Dura-mater valve prostheses are used in cardiac surgery.
Observation:
- A 30-year-old woman with a dura-mater valve prosthesis presented with infective endocarditis.
- The endocarditis was linked to acute purulent cholecystitis secondary to chronic cholelithiasis.
- Despite antibacterial treatment, refractory heart failure developed, necessitating prosthesis replacement.
Findings:
- The patient underwent surgical replacement of the infected prosthesis.
- Post-operative autopsy revealed persistent endocarditis on the bioprosthesis, purulent cholecystitis, and a gallbladder stone.
- The patient died in the post-operative period.
Implications:
- This case highlights that surgical treatment for endocarditis may fail if the underlying source of infection, such as purulent cholecystitis, is not eradicated.
- Persistent gallbladder infection can lead to reinfection of cardiac prostheses, even after replacement.
- Comprehensive management of both cardiac and potential infectious foci is crucial for successful treatment outcomes.