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Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium
Although infective endocarditis (IE) has been described in reports dating from the Renaissance, the diagnosis still challenges and the outcome often surprises. In the course of time, diagnostic criteria have been updated and validated to reduce misdiagnosis. Some risk factors and epidemiology have s...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
São Paulo, SP: Universidade de São Paulo, Hospital Universitário
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453656/ https://www.ncbi.nlm.nih.gov/pubmed/28584802 http://dx.doi.org/10.4322/acr.2013.034 |
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author | Forster, Robert de Campos, Fernando Peixoto Ferraz Lovisolo, Silvana Maria Aiello, Vera Demarchi Martines, João Augusto dos Santos |
author_facet | Forster, Robert de Campos, Fernando Peixoto Ferraz Lovisolo, Silvana Maria Aiello, Vera Demarchi Martines, João Augusto dos Santos |
author_sort | Forster, Robert |
collection | PubMed |
description | Although infective endocarditis (IE) has been described in reports dating from the Renaissance, the diagnosis still challenges and the outcome often surprises. In the course of time, diagnostic criteria have been updated and validated to reduce misdiagnosis. Some risk factors and epidemiology have shown dynamic changes since degenerative valvular disease became more predominant in developed countries, and the mean age of the affected population increased. Despite streptococci have been being well known as etiologic agents, some groups, although rare, have been increasingly reported (e.g., Streptococcus milleri.) Intracardiac complications of IE are common and have a worse prognosis, frequently requiring surgical treatment. We report a case of a middle-aged diabetic man who presented with prolonged fever, weight loss, and ultimately severe dyspnea. IE was diagnosed based on a new valvular regurgitation murmur, a positive blood culture for Streptococcus anginosus, an echocardiographic finding of an aortic valve vegetation, fever, and pulmonary thromboembolism. Despite an appropriate antibiotic regimen, the patient died. Autopsy findings showed vegetation attached to a bicuspid aortic valve with an associated septal abscess and left ventricle and aortic root fistula connecting with the pulmonary artery. A large thrombus was adherent to the pulmonary artery trunk and a pulmonary septic thromboemboli were also identified. |
format | Online Article Text |
id | pubmed-5453656 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | São Paulo, SP: Universidade de São Paulo, Hospital Universitário |
record_format | MEDLINE/PubMed |
spelling | pubmed-54536562017-06-05 Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium Forster, Robert de Campos, Fernando Peixoto Ferraz Lovisolo, Silvana Maria Aiello, Vera Demarchi Martines, João Augusto dos Santos Autops Case Rep Article / Autopsy Case Report Although infective endocarditis (IE) has been described in reports dating from the Renaissance, the diagnosis still challenges and the outcome often surprises. In the course of time, diagnostic criteria have been updated and validated to reduce misdiagnosis. Some risk factors and epidemiology have shown dynamic changes since degenerative valvular disease became more predominant in developed countries, and the mean age of the affected population increased. Despite streptococci have been being well known as etiologic agents, some groups, although rare, have been increasingly reported (e.g., Streptococcus milleri.) Intracardiac complications of IE are common and have a worse prognosis, frequently requiring surgical treatment. We report a case of a middle-aged diabetic man who presented with prolonged fever, weight loss, and ultimately severe dyspnea. IE was diagnosed based on a new valvular regurgitation murmur, a positive blood culture for Streptococcus anginosus, an echocardiographic finding of an aortic valve vegetation, fever, and pulmonary thromboembolism. Despite an appropriate antibiotic regimen, the patient died. Autopsy findings showed vegetation attached to a bicuspid aortic valve with an associated septal abscess and left ventricle and aortic root fistula connecting with the pulmonary artery. A large thrombus was adherent to the pulmonary artery trunk and a pulmonary septic thromboemboli were also identified. São Paulo, SP: Universidade de São Paulo, Hospital Universitário 2013-12-31 /pmc/articles/PMC5453656/ /pubmed/28584802 http://dx.doi.org/10.4322/acr.2013.034 Text en Copyright © 2013 Autopsy and Case Reports http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed of terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided article is properly cited. |
spellingShingle | Article / Autopsy Case Report Forster, Robert de Campos, Fernando Peixoto Ferraz Lovisolo, Silvana Maria Aiello, Vera Demarchi Martines, João Augusto dos Santos Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title | Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title_full | Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title_fullStr | Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title_full_unstemmed | Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title_short | Infective endocarditis with left to right intracardiac fistula due to Streptococcus anginosus - a rare complication caused by an even rarer bacterium |
title_sort | infective endocarditis with left to right intracardiac fistula due to streptococcus anginosus - a rare complication caused by an even rarer bacterium |
topic | Article / Autopsy Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453656/ https://www.ncbi.nlm.nih.gov/pubmed/28584802 http://dx.doi.org/10.4322/acr.2013.034 |
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