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Subacute infective endocarditis presenting with an isolated splenic infarction
Maen Mhd Baroudi1, Mohamed Kamal Sabra1, Hassan Abuzaid1
1Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
Idcases
|April 17, 2023
Summary
Subacute endocarditis can manifest unusually as splenic infarction without typical fever or malaise. Early diagnosis via transesophageal echocardiography (TEE) is crucial for prompt treatment of infective endocarditis.
Area of Science:
- Cardiology
- Infectious Diseases
- Gastroenterology
Background:
- Subacute endocarditis typically presents with insidious onset over weeks to months, characterized by low-grade fever, malaise, anorexia, and weight loss.
- This case presents an atypical manifestation of subacute endocarditis.
Observation:
- A 48-year-old male presented with acute left hypochondrial pain, diagnosed as splenic infarction via CT abdomen.
- Initial investigations for the splenic infarct were inconclusive.
- Transesophageal echocardiography (TEE) revealed a mobile mass on the aortic valve, indicating infective endocarditis.
Findings:
- Blood cultures identified Streptococcus viridians as the causative agent.
- The patient received intravenous antibiotics for treatment of infective endocarditis.
- Splenic infarction was the sole presenting symptom, with absence of typical endocarditis symptoms.
Implications:
- This case underscores the importance of considering infective endocarditis in patients with unexplained splenic infarction.
- TEE is a critical diagnostic tool for identifying cardiac masses in such cases.
- Prompt diagnosis and treatment of endocarditis are essential to prevent complications.
Keywords:
Abdominal painBacteremiaEchocardiogramHeart failureInfective endocarditisSplenic infarctionValve regurgitationMore Related Videos
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