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Infective endocarditis with embolic renal infarct presenting as acute abdomen
1Department of Emergency, Al Ain Hospital, Al Ain, United Arab Emirates.
Clinical and Experimental Emergency Medicine
|July 8, 2021
Summary
Infective endocarditis (IE) can mimic surgical abdomen symptoms. Early diagnosis and treatment are crucial, especially in high-risk patients like intravenous drug users, to prevent serious complications such as renal infarction.
Area of Science:
- Cardiology
- Infectious Diseases
- Radiology
Background:
- Infective endocarditis (IE) is a rare but serious infection of the heart lining or valves.
- Diagnosis can be challenging due to non-specific symptoms.
Observation:
- A 28-year-old male with sickle cell trait and a history of intravenous drug use presented with abdominal pain and hematuria.
- Initial imaging suggested cholecystitis or pyelonephritis, but further review revealed pulmonary septic emboli and renal infarct.
Findings:
- The patient was diagnosed with infective endocarditis causing an embolic renal infarct.
- Treatment with 60 days of intravenous antibiotics led to remarkable recovery.
Implications:
- This case highlights that infective endocarditis can present as a surgical abdomen.
- Multiple imaging modalities may be necessary for accurate diagnosis of IE-related complications.
- Unexplained flank pain in high-risk individuals warrants suspicion for acute renal infarction secondary to IE.
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