Endocarditis lenta-patient survived septic shock: a case report

Authors

  • Amra Macić Džanković The Department of Internal Medicine - Cardiology, General Hospital ''Prim. Dr. Abdulah Nakaš'', Kranjčevićeva 12, 71000 Sarajevo, Bosnia and Herzegovina.
  • Nina Burina The Department of Internal Medicine - Cardiology, General Hospital ''Prim. Dr. Abdulah Nakaš'', Kranjčevićeva 12, 71000 Sarajevo, Bosnia and Herzegovina.
  • Mehmed Kulić Heart Center,Clinical Center Sarajevo, Bolnička 25, 71000 Sarajevo
  • Snježana Mehanić Clinic for Infective Diseases,Clinical Center Sarajevo, Bolnička 25, 71000 Sarajevo

DOI:

https://doi.org/10.17532/jhsci.2012.55

Keywords:

Endocardtitis lenta, prosthetic valve infection, septic shock, false positive Q-fever

Abstract

Infective endocarditis is defi ned as an infection of the endocardial surface of the heart. Its intracardiac effects include severe valvular insuffi ciency, which may lead to intractable congestive heart failure and myocardial
abscesses. This disease still carries a poor prognosis and a high mortality.
A severe case of infective endocarditis with its complications is presented. A man with aortic prosthetic valve due to earlier aortic stenosis and corrected aortal coarctation and implanted pacemaker presented
with prolonged unexplained fever, malaise, sweating, weight loss (15 kg/4 months) and lumbar pain. He was treated with broad-spectrum antibiotics prior IE diagnosis was considered. Echocardiogram showed
aortic vegetations and possible periaortal abscess formation. Nonspecifi c infl ammation parameters were high positive. Cultures were constantly negative. His condition had deteriorated suddenly, and he had presented
with worsening of cutaneous vasculitis, subacute glomerulonephritis and subsequent acute respiratory distress syndrome and septic shock. This patient survived with residual bilateral necrosis of the feet and
toxic peroneal paresis. At the end transthoracic echocardiogram showed enlarged heart chambers, LV mild dilated and concentric hypertrophy with ejection fraction about 40%, degenerative postinfl ammatory mitral
valve changes, mild mitral regurgitation and tricuspid regurgitation, postinfl ammatory aortic root fi brosis and moderate aortic valve stenosis (AVPG max 50,9 mmHg, AVPG mean 24 mmHg) with no pericardial effusion. Initial suspicion of Q fever was defi nitely excluded by serological testing showing nonspecifi c IgM positivity,
probably rheumatoid factor related.

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Published

15.09.2012

Issue

Section

Research articles

How to Cite

1.
Endocarditis lenta-patient survived septic shock: a case report. JHSCI [Internet]. 2012 Sep. 15 [cited 2024 Jul. 18];2(2):153-8. Available from: https://www.jhsci.ba/ojs/index.php/jhsci/article/view/74