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[Misunderstood symptoms in patients with infectious endocarditis]
1Academisch Ziekenhuis, Hart Long Instituut, afd. Cardiologie, Utrecht.
Abstract:
Infectious endocarditis was diagnosed in four patients, men aged 18, 44, 35 and 22; the bacteria involved were Streptococcus viridans, Eikenella corrodens, Staphylococcus aureus and Streptococcus mutans, respectively. In all patients mycotic aneurysms were observed which had led to seemingly unrelated neurological or abdominal complaints. In one patient an aneurysm of the A. cerebri media resolved in two years, another patient died following fatal bleeding of a ruptured aneurysm in the A. hepatica propria. Mycotic aneurysms may be found in all parts of the body. This complication is often diagnosed too late because it is not considered.
Insights
Infectious endocarditis can cause mycotic aneurysms in various body locations, leading to diverse symptoms. Early consideration of these aneurysms is crucial for timely diagnosis and improved patient outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Neurology
Background:
- Infectious endocarditis is a serious infection affecting heart valves.
- Mycotic aneurysms are a potential complication, often presenting with varied symptoms.
Observation:
- Four male patients (aged 18-44) with infectious endocarditis were studied.
- Causative bacteria included Streptococcus viridans, Eikenella corrodens, Staphylococcus aureus, and Streptococcus mutans.
- All patients presented with mycotic aneurysms causing neurological or abdominal issues.
Findings:
- Mycotic aneurysms occurred in different locations, including the middle cerebral artery and hepatic artery.
- One middle cerebral artery aneurysm spontaneously resolved over two years.
- A ruptured hepatic artery aneurysm resulted in a fatal outcome for one patient.
Implications:
- Mycotic aneurysms are a significant complication of infectious endocarditis.
- These aneurysms can manifest in any part of the body.
- Delayed diagnosis is common due to a lack of consideration for this complication.