Infective Endocarditis as a Complication of Crohn’s Disease on Immunotherapy

Abstract

A patient with a history of Crohn's disease on infliximab presented to the hospital with sepsis and a new heart murmur. He was found to have native aortic valve infective endocarditis from a rare species of group D Streptococcus in his blood. The patient was also noted to be in an acute flare of Crohn's disease. The hospital course was complicated by florid heart failure from acute aortic insufficiency. He eventually improved after source control and appropriate antibiotic therapy. S. pasteuranis bacteremia and endocarditis are attributable to the patient's immunocompromised state as a result of infliximab treatment. While S. pasteuranis is infrequently grown in blood cultures, it is commonly found in normal gut flora. We hypothesize that it gained access to the bloodstream through the epithelium in the terminal ileum, which was inflamed due to an acute flare of Crohn's disease.

An Interesting Case of Disseminated Histoplasmosis in a Patient With Hemophagocytic Lymphohistiocytosis

“…Data from two large urban outbreaks in Indianapolis suggested that immunosuppression, older age, and coexisting chronic illnesses were the primary risk factors for acquiring disseminated histoplasmosis [ 18 ]. It is well-known that an immunocompromised state and old age predispose to disseminated infections [ 19 , 20 ]. Of the 66 cases of disseminated histoplasmosis reviewed in the above study, two-thirds of patients reported some combination of central nervous system findings, splenomegaly, hepatomegaly, and lymphopenia [ 18 ].…”

The Impact of a Vegan Diet on Many Aspects of Health: The Overlooked Side of Veganism

“…An optimal diet should be balanced, consisting of lean meat, nuts, fresh fruits and vegetables, and olive oil (Figure 1) [8,9]. A wholesome diet is essential in maintaining a healthy gut flora, which in turn is pivotal in avoiding inflammatory disorders [10][11][12][13]. The primary aim of this review will be to draw attention to the current literature associated with veganism, including the side effects of practicing a VD and long-term consequences for a variety of populations, including adults, adolescents, pregnant and lactating women, and the fetal outcomes of vegan mothers.…”