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Aortic valve endocarditis with root abscess causing superior vena cava obstruction: a case report.
Malo Marcel Francois Scullion1, Peter Lynn1, Adam Marshall1
1Cardiology Department, University Hospital Hairmyres, Eaglesham Road, East Kilbride, Glasgow G75 8RG, UK.
European Heart Journal. Case Reports
|January 9, 2020
Summary
This case report details the first instance of infective endocarditis causing a root abscess and superior vena cava (SVC) obstruction. Symptoms improved spontaneously, highlighting potential collateral circulation in rare cases of Streptococcus anginosus endocarditis.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Reports the first case of infective endocarditis causing a root abscess and superior vena cava (SVC) obstruction.
- Highlights Streptococcus anginosus as a rare pathogen associated with abscess formation.
Observation:
- An 84-year-old male with prosthetic valve replacement presented with S. anginosus endocarditis, root abscess, and subsequent SVC obstruction.
- Clinical signs of SVC obstruction developed despite antibiotic treatment, with imaging revealing an enlarging abscess.
- Surgical intervention was deemed unsuitable due to abscess size and vascular involvement.
Findings:
- The patient's SVC obstruction symptoms improved spontaneously within weeks, attributed to collateral venous circulation.
- Streptococcus anginosus endocarditis, though rare, is linked to abscess formation and carries risks for older males with prior cardiac surgery.
Implications:
- This case expands the differential diagnosis for SVC obstruction, including infective endocarditis with abscess.
- The spontaneous improvement suggests a potential role for conservative management or the body's natural compensatory mechanisms in select cases.
- Recognizes risk factors for S. anginosus endocarditis, including advanced age, male gender, and history of cardiac surgery.
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