Infective endocarditis complicating COVID-19 pneumonia: a case report

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• The COVID-19 pandemic necessitated careful consideration of cardiovascular imaging procedures like transoesophageal echocardiography (TOE) due to contamination risks.
• Transthoracic echocardiography (TTE) and TOE are primary diagnostic tools for infective endocarditis (IE).
• This case represents the first documented instance of IE complicating COVID-19.

Purpose of the Study:

• To report a case of infective endocarditis in a patient with severe COVID-19 pneumonia.
• To highlight the role of echocardiography in diagnosing IE during the COVID-19 pandemic.
• To emphasize the importance of safety measures for healthcare personnel during echocardiography.

Main Methods:

• A 57-year-old male with severe COVID-19 pneumonia underwent mechanical ventilation.
• Transthoracic echocardiography (TTE) was initially performed but did not reveal endocardial vegetations.
• Transoesophageal echocardiography (TOE) was subsequently conducted, identifying IE of the aortic valve.

Main Results:

• The patient developed fever and positive blood cultures for methicillin-resistant Staphylococcus aureus.
• Transoesophageal echocardiography confirmed IE of the aortic valve.
• Antibiotic therapy led to resolution of sepsis and improved inflammatory markers.

Conclusions:

• Echocardiography (TTE and TOE) remains essential for diagnosing IE in COVID-19 patients, even with associated risks.
• If IE is suspected, TTE or TOE are mandatory, with TOE used if TTE is inconclusive.
• Healthcare personnel must implement stringent preventive measures to avoid viral contamination during echocardiographic examinations.