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Vasculitis and cerebral hemorrhage due to Streptococcus gordonii infectious endocarditis: A case report

César Augusto Arias Velásquez1, Juan Esteban Quiroz Álvarez1, Tomás Urrego Callejas1

  • 1Emergency Department, Hospital Pablo Tobón Uribe, Medellín, Colombia.

SAGE Open Medical Case Reports
|January 31, 2024
PubMed

Insights

Infective endocarditis, a heart infection, can cause central nervous system issues like intracranial hemorrhage. This case highlights Streptococcus gordonii endocarditis leading to vasculitis and hemorrhage in a young patient.

Area of Science:

  • Cardiology
  • Neurology
  • Infectious Diseases

Background:

  • Infective endocarditis (IE) is a serious heart valve infection with potential systemic complications.
  • Central nervous system (CNS) involvement in IE is common, often presenting as ischemic stroke.
  • Intracranial hemorrhage (ICH) is a less common but severe neurological complication of IE.

Observation:

  • A 21-year-old male with no prior medical history presented with spontaneous intracranial hemorrhage.
  • Diagnostic workup revealed Streptococcus gordonii infective endocarditis as the underlying cause.
  • The ICH was attributed to a vasculitis phenomenon secondary to the endocarditis.

Findings:

  • The patient underwent successful emergency drainage of the intracranial hemorrhage.
  • Minimally invasive valve surgery was performed 17 days post-presentation.
  • The patient experienced a satisfactory postoperative recovery and follow-up.

Implications:

  • This case underscores the importance of considering infective endocarditis in young patients presenting with neurological events, including intracranial hemorrhage.
  • Prompt diagnosis and multidisciplinary management, involving neurosurgery, cardiology, and infectious disease specialists, are crucial for favorable outcomes.
  • Minimally invasive surgical approaches may be beneficial in selected patients with IE and associated complications.

Keywords:
Infectious endocarditiscardiac surgical procedurescerebral hemorrhagevasculitis

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