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Aortic and tricuspid endocarditis in hemodialysis patient with systemic and pulmonary embolism

This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thor...

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Detalles Bibliográficos
Autores principales: Rosa, Silvia Aguiar, Germano, Nuno, Santos, Ana, Bento, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação Brasileira de Medicina intensiva 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489788/
https://www.ncbi.nlm.nih.gov/pubmed/26340160
http://dx.doi.org/10.5935/0103-507X.20150031
Descripción
Sumario:This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thoracoabdominal computerized tomography scan revealed septic pulmonary embolus. The patient underwent empirical antibiotherapy with ceftriaxone, gentamicin and vancomycin, and the therapy was changed to flucloxacilin and gentamicin after the isolation of S. aureus in blood cultures. The multidisciplinary team determined that the patient should undergo valve replacement after the stabilization of the intracranial hemorrhage; however, on the 8(th) day of hospitalization, the patient entered cardiac arrest due to a massive septic pulmonary embolism and died. Despite the risk of aggravation of the hemorrhagic cerebral lesion, early surgical intervention should be considered in high-risk patients.