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Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage
BACKGROUND: Endocarditis is more common in patients with cardiac prostheses. A Bentall procedure entails surgical replacement of the aortic valve, aortic root, and ascending aorta with re-implantation of coronary arteries into the graft. CASE: 65-year-old male with history of atrial fibrillation on...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9945769/ https://www.ncbi.nlm.nih.gov/pubmed/36845909 http://dx.doi.org/10.1016/j.idcr.2023.e01710 |
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author | Wahbah Makhoul, Gennifer Mustafa, Ahmad Ling, Joanne Asogwa, Nnedindu Elhosseiny, Sherif Siddiqui, Fasih Sami Khan, Shahkar Lafferty, James C. Glaser, Allison |
author_facet | Wahbah Makhoul, Gennifer Mustafa, Ahmad Ling, Joanne Asogwa, Nnedindu Elhosseiny, Sherif Siddiqui, Fasih Sami Khan, Shahkar Lafferty, James C. Glaser, Allison |
author_sort | Wahbah Makhoul, Gennifer |
collection | PubMed |
description | BACKGROUND: Endocarditis is more common in patients with cardiac prostheses. A Bentall procedure entails surgical replacement of the aortic valve, aortic root, and ascending aorta with re-implantation of coronary arteries into the graft. CASE: 65-year-old male with history of atrial fibrillation on rivaroxaban, bicuspid aortic valve, and ascending aortic aneurysm with a history of a Bentall procedure two years prior, presented with headache and dysarthria for one day. National Institutes of Health Stroke Scale was 3 and CT head showed 2.7 cm left frontal hematoma with extension into the subarachnoid space. Andexanet alfa was given for rivaroxaban reversal followed by cerebral angiogram which showed 5 mm intracranial inferior MCA aneurysm and embolization and coil placement was done. Blood cultures grew Lactococcus garvieae and transesophageal echocardiogram revealed aortic valve thickening and vegetation on the non-coronary cusp. He was subsequently treated with six weeks of IV ceftriaxone and Gentamycin. CONCLUSION: With increasing use of bioprosthetic valves, the possibility of infective endocarditis with uncommon pathogens should be kept in mind. Lactococcus commonly affects native valves, however it can affect bioprosthetic valves and can present with mycotic aneurysms. |
format | Online Article Text |
id | pubmed-9945769 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-99457692023-02-23 Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage Wahbah Makhoul, Gennifer Mustafa, Ahmad Ling, Joanne Asogwa, Nnedindu Elhosseiny, Sherif Siddiqui, Fasih Sami Khan, Shahkar Lafferty, James C. Glaser, Allison IDCases Case Report BACKGROUND: Endocarditis is more common in patients with cardiac prostheses. A Bentall procedure entails surgical replacement of the aortic valve, aortic root, and ascending aorta with re-implantation of coronary arteries into the graft. CASE: 65-year-old male with history of atrial fibrillation on rivaroxaban, bicuspid aortic valve, and ascending aortic aneurysm with a history of a Bentall procedure two years prior, presented with headache and dysarthria for one day. National Institutes of Health Stroke Scale was 3 and CT head showed 2.7 cm left frontal hematoma with extension into the subarachnoid space. Andexanet alfa was given for rivaroxaban reversal followed by cerebral angiogram which showed 5 mm intracranial inferior MCA aneurysm and embolization and coil placement was done. Blood cultures grew Lactococcus garvieae and transesophageal echocardiogram revealed aortic valve thickening and vegetation on the non-coronary cusp. He was subsequently treated with six weeks of IV ceftriaxone and Gentamycin. CONCLUSION: With increasing use of bioprosthetic valves, the possibility of infective endocarditis with uncommon pathogens should be kept in mind. Lactococcus commonly affects native valves, however it can affect bioprosthetic valves and can present with mycotic aneurysms. Elsevier 2023-02-13 /pmc/articles/PMC9945769/ /pubmed/36845909 http://dx.doi.org/10.1016/j.idcr.2023.e01710 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Case Report Wahbah Makhoul, Gennifer Mustafa, Ahmad Ling, Joanne Asogwa, Nnedindu Elhosseiny, Sherif Siddiqui, Fasih Sami Khan, Shahkar Lafferty, James C. Glaser, Allison Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title | Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title_full | Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title_fullStr | Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title_full_unstemmed | Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title_short | Lactococcus endocarditis after Bentall procedure presenting with intracranial hemorrhage |
title_sort | lactococcus endocarditis after bentall procedure presenting with intracranial hemorrhage |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9945769/ https://www.ncbi.nlm.nih.gov/pubmed/36845909 http://dx.doi.org/10.1016/j.idcr.2023.e01710 |
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