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Mitral Valve Endocarditis Secondary to Nasal Irrigation Use in Chronic Allergic Rhinitis.
Bradley Casey1, Destinee Hua1, James Barton1
1Internal Medicine, Cape Fear Valley Medical Center, Fayetteville, USA.
Cureus
|October 13, 2022
Summary
This case report details a rare instance of infective endocarditis caused by Streptococcus mitis, originating from nasal irrigation. It underscores the importance of nasal hygiene in preventing valvular heart disease.
Area of Science:
- Cardiology
- Infectious Diseases
- Microbiology
Background:
- Streptococcus mitis commonly colonizes the upper respiratory tract.
- Infective endocarditis (IE) is often linked to oral pathogens and dental procedures.
- Nasopharyngeal sources of IE, particularly from nasal irrigation, are infrequently reported.
Observation:
- A 49-year-old woman with allergic rhinitis presented with symptoms suggestive of IE.
- Initial transthoracic echocardiogram was inconclusive, but transesophageal echocardiography revealed mitral valve vegetation.
- Despite antibiotic treatment, the patient had persistent vegetation, indicating a challenging infection.
Findings:
- Mitral valve infective endocarditis was diagnosed.
- The likely source was identified as nasal irrigation, highlighting a less common etiology.
- The infection proved resistant to standard antibiotic therapy.
Implications:
- Poor nasal hygiene can be an overlooked cause of valvular endocarditis.
- Clinicians should consider nasal irrigation practices in patients with IE, especially those with chronic rhinitis.
- Patients using nasal irrigation should be advised to discontinue use if epistaxis occurs to prevent potential complications.
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