An infective endocarditis complicated by multiple septic emboli: case report

Abstract

Background Owing to challenges associated with heart failure and cardiac embolism, infectious endocarditis emerges as a critical pathology characterized by elevated mortality and morbidity rates. Our case stands out as a rare instance of endocarditis involving multisystem embolization, with a successful outcome. Case presentation We present the case of an 81-year-old man whose admission was further complicated by various septic emboli affecting the brain (manifesting as a brain abscess and ischemic stroke), spleen (resulting in splenic infarction), and spinal cord. The patient received a diagnosis of infective endocarditis affecting the native mitral valve. Following prompt medical and surgical intervention, the overall progression was favorable despite encountering several challenges. Conclusions This case is notable for its detailed description and analysis of the multiple embolic events. More importantly, it underscores the significance of timely surgical intervention and the collaborative approach of a heart team in the face of complicated endocarditis marked by numerous septic emboli. Despite the typically grim prognosis associated with such cases, the outcomes emphasize the positive impact of timely surgery on prognosis.

Multidisciplinary Perspectives of Challenges in Infective Endocarditis Complicated by Septic Embolic-Induced Acute Myocardial Infarction

“…Some cases described infective endocarditis with rare embolization of the posterior descending artery [ 29 , 47 ]. Embolization in multiple arterial territories is also described in the literature, such as embolization from the aortic valve to the coronary arteries, concomitant with embolization to the arteries of the upper limbs [ 20 ] and embolization from the mitral valve to the cerebral, splenic, and spinal levels [ 4 ].…”

“…The septic embolic event is a common complication in IE [ 3 ] and is associated with a poor prognosis. Left-side heart valves’ infection often has the highest embolic risk [ 4 ]. Surgical intervention is highly controversial for septic EE prevention, whereas surgery is well-established for HF and UI management [ 5 ].…”