An unusual agent for an unusual localization of infective endocarditis

Abstract

We report on a 32-year-old male patient with acute left-hemispheric stroke caused by embolism due to infective endocarditis affected from the HACEK group. Additionally, atypical findings from the transesophageal echocardiography (TEE) which showed fluttering structures belonging to the papillary muscle could be proven as infectious agents with the help of a glucose positron emission tomography (PET) scan. TEE controls showed increasing vegetation involving the mitral valve so that surgery became necessary. The current work reflects, in detail, the emergent clinical course of this young patient, suffering from both an unusual localization and an infrequent cause of endocarditis and focuses on an actual view to the literature.

Varicella Associated to Acute Myocardial Infarction Caused by Infective Endocarditis

“…3,8 On the echocardiogram of this case (Figure 3D), a vegetation of 28 × 8 mm can be seen on the anterolateral papillary muscle. This is an unusual implantation site for vegetations originating with other pathogens 9,10 and had not been documented for S pyogenes . The risk of rupture of vegetations and/or papillary muscles is high when the former are >10 mm in diameter and according to the criteria of the European Society of Cardiology is an indication for emergency surgery.…”