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Updated: Aug 6, 2026
09:01
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Infective Endocarditis Presenting with Rapidly Progressive Cerebral Microbleeds and Multiple Intracerebral
Kazumasa Sekiguchi1, Jun Sawada1, Kosuke Matsuzono1
1Division of Neurology, Department of Medicine, Jichi Medical University, Japan.
Internal Medicine (Tokyo, Japan)
|July 20, 2026
Summary
Infective endocarditis (IE) can cause multiple brain hemorrhages, especially in patients on anticoagulants. Prompt antibiotic treatment led to a favorable outcome in this case of IE with Streptococcus mitis/oralis.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- Infective endocarditis (IE) is a significant cause of neurological complications.
- Hemorrhagic stroke, including intracerebral hemorrhages (ICHs) and cerebral microbleeds (CMBs), can occur in IE patients.
- Patients with prosthetic heart valves on anticoagulant therapy are at increased risk.
Purpose of the Study:
- To highlight the association between IE, anticoagulant therapy, and multiple cerebral hemorrhages.
- To emphasize the importance of considering IE in the differential diagnosis of multiple ICHs and CMBs.
- To report a case of IE with Streptococcus mitis/oralis presenting with multiple ICHs and CMBs.
Main Methods:
- Case report of a 65-year-old male patient.
- Diagnosis of IE based on clinical presentation and microbiological findings.
- Imaging studies to identify intracerebral hemorrhages and cerebral microbleeds.
Main Results:
- The patient developed multiple ICHs and CMBs.
- IE was diagnosed and attributed to Streptococcus mitis/oralis.
- The patient recovered fully with antibiotic treatment alone.
Conclusions:
- IE should be considered in patients presenting with multiple cerebral hemorrhages, particularly those on anticoagulant therapy.
- Anticoagulant therapy may exacerbate or contribute to the development of multiple ICHs and CMBs in the context of IE.
- Early diagnosis and appropriate antibiotic treatment of IE are crucial for favorable neurological outcomes.
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