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Bacterial endocarditis following COVID-19 infection: two case reports
Elham Barahimi1, Sahar Defaee1, Rahele Shokraei2
1Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Insights
This case report highlights that bacterial endocarditis can be a rare complication in COVID-19 patients treated with tocilizumab and corticosteroids. Early diagnosis and surgical intervention are crucial for recovery from this serious infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Immunology
Background:
- COVID-19 pandemic necessitated diverse treatment strategies, including immunomodulatory agents.
- While effective, treatments like tocilizumab and corticosteroids can increase risks of secondary infections.
- Bacterial endocarditis is a less common cardiac complication in SARS-CoV-2 patients.
Observation:
- Two patients with COVID-19, treated with tocilizumab and corticosteroids, developed suspected infective endocarditis.
- Both patients presented with distinct symptoms and tested positive for Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia.
- Diagnosis was confirmed, necessitating open-heart surgery and valve replacement.
Findings:
- Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis developed in two immunocompromised COVID-19 patients.
- Successful surgical intervention and medical management led to patient recovery.
- This suggests a potential link between specific COVID-19 treatments and endocarditis.
Implications:
- Clinicians should consider bacterial endocarditis in COVID-19 patients presenting with relevant symptoms, especially those on immunosuppressive therapy.
- Awareness of this potential complication is vital for timely diagnosis and management.
- Further research is needed to elucidate the precise mechanisms and risk factors.
Background:
COVID-19, an emerging disease raised as a pandemic, urgently needed treatment choices. Some options have been confirmed as lifesaving treatments, but long-term complications must be clearly illustrated. Bacterial endocarditis is a less frequent disease among patients infected with SARS_COV_2 compared to other cardiac comorbidities in these patients. This case report discusses bacterial endocarditis as a potential adverse effect after administering tocilizumab, corticosteroids, and COVID-19 infection.
Case Presentation:
In the first case, a 51-year-old Iranian female housewife was admitted to the hospital with fever, weakness, and monoarthritis symptoms. The second case is a 63-year-old Iranian woman who is a housewife admitted with weakness, shortness of breath, and extreme sweating. Both cases tested positive for Polymerase chain reaction (PCR) less than one month ago and were treated with tocilizumab and corticosteroid. Both patients were suspected of infective endocarditis. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in the blood cultures of both patients. The diagnosis of endocarditis is confirmed for both cases. Cases are subjected to open-heart surgery, a mechanical valve is placed, and they are treated with medication. In subsequent visits, their condition was reported to be improving.
Conclusion:
Adjacent to cardiovascular inclusion as COVID-19 disease complications, secondary infection taken after the organisation of immunocompromising specialists can result in basic maladies and conditions counting infective endocarditis.
Related Concept Videos
Endocarditis I: Introduction
Endocarditis II: Clinical Features of Infective Endocarditis
Endocarditis III: Medical Management
Endocarditis IV: Nursing Management
Myocarditis II: Clinical Features and Diagnostic Tests
Myocarditis III: Medical Management

