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Complex case of COVID-19 and infective endocarditis
Katrin Alizadeh1, Danielle Bucke2, Sadia Khan3
1Haematology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK katrin.alizadeh@nhs.net.
BMJ Case Reports
|August 4, 2021
Summary
A COVID-19 patient developed severe sepsis and Staphylococcus aureus infective endocarditis. Complications included acute renal failure, spinal discitis, and extensive thrombosis, leading to toe ischemia and amputation.
Area of Science:
- Infectious Diseases
- Cardiology
- Nephrology
Background:
- Coronavirus disease 2019 (COVID-19) can trigger severe systemic inflammatory responses.
- Staphylococcus aureus bacteraemia is a serious complication associated with high morbidity and mortality.
- Infective endocarditis (IE) is an infection of the heart valves, often caused by bacteria.
Observation:
- A 50-year-old man with COVID-19 presented with confusion and dyspnea, progressing to severe sepsis and acute renal failure.
- Echocardiogram revealed aortic valve vegetation, confirming Staphylococcus aureus infective endocarditis.
- The patient experienced multiple embolic and thrombotic events, including spinal discitis, peripheral ischemia, and deep vein thrombosis.
Findings:
- The case highlights the potential for severe, multi-systemic complications arising from COVID-19.
- Staphylococcus aureus IE can manifest with diverse embolic phenomena affecting various organs.
- Prompt diagnosis and management of IE are crucial to prevent catastrophic outcomes.
Implications:
- This case underscores the importance of considering IE in patients with COVID-19 presenting with sepsis and unexplained organ dysfunction.
- Early recognition and treatment of IE can mitigate the risk of severe embolic and thrombotic complications.
- Further research into the interplay between viral infections and bacterial endocarditis is warranted.
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