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Subacute bacterial endocarditis causing disseminated intravascular coagulation: resolution after valve replacement
The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1984
Summary
Culture-negative bacterial endocarditis and disseminated intravascular coagulation (DIC) resistant to antibiotics and heparin resolved rapidly after prosthetic valve replacement. This highlights valve surgery as a critical intervention for complex endocarditis-associated coagulopathy.
Area of Science:
- Cardiology
- Hematology
- Infectious Diseases
Background:
- Subacute bacterial endocarditis (SBE) can present with complex systemic complications.
- Disseminated intravascular coagulation (DIC) is a severe coagulopathy that can arise secondary to infections, including endocarditis.
Observation:
- A case of culture-negative SBE complicated by refractory DIC was observed.
- Standard treatments including antibiotics and heparin were ineffective in managing the coagulopathy.
Findings:
- Successful resolution of DIC occurred within 24 hours following prosthetic valve replacement.
- The primary source of infection and coagulopathy was identified as the affected heart valves.
Implications:
- Prosthetic valve replacement should be considered a crucial therapeutic option for managing endocarditis-associated DIC unresponsive to conventional therapies.
- This case underscores the importance of addressing the underlying valvular pathology in complex infectious-coagulopathic syndromes.