Gonococcal endocarditis during pregnancy: simultaneous cesarean section and aortic valve surgery

Area of Science:

• Cardiology
• Infectious Diseases
• Obstetrics

Background:

• Disseminated gonococcal infection can lead to rare but severe gonococcal endocarditis.
• Endocarditis during pregnancy presents unique diagnostic and management challenges.
• Co-infection with Serratia species is exceptionally uncommon in gonococcal endocarditis.

Observation:

• A pregnant patient at 30 weeks' gestation presented with symptoms of disseminated gonococcal infection.
• Rapid aortic valve destruction led to severe congestive heart failure and fetal distress.
• Culture results confirmed a co-infection of Neisseria gonorrhoeae and Serratia species.

Findings:

• This is the first reported case of culture-proven gonococcal and Serratia endocarditis in pregnancy.
• The patient experienced rapid hemodynamic deterioration due to aortic valve destruction.
• Fetal distress was directly linked to maternal cardiac decompensation.

Implications:

• Highlights the critical need for prompt diagnosis and management of disseminated gonococcal infections in pregnant individuals.
• Emphasizes the potential for severe cardiac complications, including endocarditis, even in the absence of typical risk factors.
• Underscores the importance of multidisciplinary care involving cardiology, infectious diseases, and obstetrics for optimal outcomes in complex cases.