A Rare Presentation of Perivalvular Abscess and Infective Valve Endocarditis as Multiple Cerebral Septic Emboli Mimicking Ischemic Stroke

The perivalvular cardiac abscess is a severe condition associated with infective endocarditis, leading to significant morbidity and mortality if not diagnosed and managed promptly. Neurological complications, particularly stroke, can occur due to embolic events resulting from cardiac abscesses. A 63-year-old female with end-stage renal disease and multiple comorbidities presented with altered mental status. Imaging revealed acute ischemic infarcts in the frontotemporal lobes, suggesting the embolic phenomenon. Blood cultures grew Enterococcus faecalis, and an echocardiogram showed severe aortic valve destruction with perivalvular abscess. Cardiac abscesses can cause severe complications, including tissue destruction, valve damage, and embolic events. Echocardiography is crucial for diagnosis, detecting vegetation, and assessing associated complications. Transthoracic echocardiography is reliable but has limitations, whereas transesophageal echocardiography is highly sensitive. Prompt antibiotic therapy and surgical intervention are crucial for treatment. Early initiation of appropriate antibiotic therapy and surgical intervention is crucial for positive outcomes. The choice of treatment should be individualized based on the patient's specific condition and the medical team's expertise.