Infective endocarditis without biological inflammatory syndrome: Description of a particular entity

Ribeyrolles, Sophie; Ternacle, Julien; San, Sovannarith; Lepeule, R.; Moussafeur, Amina; Faivre, Laureline; Nahory, Louis; Huguet, R; Gallien, Sébastien; Decousser, Jean-Winocq; Fihman, Vincent; Fiore, Antonio; Lim, Pascal; Oliver, Léopold

doi:10.1016/j.acvd.2019.02.005

Cited by 12 publications

(5 citation statements)

References 24 publications

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“…This is consistent with previous studies which suggest that a low CRP does not exclude infective endocarditis. 8 Cultures positive for C. acnes are likely related to the history of truncal furuncles. Cutibacterium acnes is a common microbe in acne and may have a predilection for prosthetic valves.…”

Section: Discussionmentioning

confidence: 99%

Complete embolization of a mechanical aortic valve during trail running—a case report with a lucky ending

Dalen

Graven

Slagsvold

et al. 2022

European Heart Journal - Case Reports

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Background Complete embolization of a prosthetic heart valve is extremely rare and dangerous. This case reports a total embolization of a mechanical aortic valve and contributes to the literature regarding the diagnostic challenges related to infective endocarditis and follow-up after valvular surgery. Case summary A 28-year-old male 11.5 years status-post a mechanical aortic valve replacement presented with acute onset of chest pain and dyspnoea while jogging. The patient lost consciousness and went into cardiopulmonary arrest with acute pulmonary oedema and circulatory shock. An echocardiogram revealed an empty aortic annulus, and a chest radiograph showed an embolized valve in the aortic arch. The patient underwent emergent removal of the embolized valve and replacement with a new mechanical aortic valve. The patient survived with minimal sequelae. At a 3-month follow-up, he had resumed work, and the only sequelae were mild left ventricular dysfunction and minor vision loss. Although he experienced no warning signs or symptoms, the most likely aetiology for embolization of the valvular prosthesis was infective endocarditis, which was revealed by re-evaluation of an echocardiogram recorded 1 month before the presentation which demonstrated a subtle motion abnormality of the valve. Conclusions We present a case of a late complete embolization of a mechanical aortic valve most likely caused by asymptomatic infective endocarditis. The case illustrates the challenges in follow-up after valvular surgery and highlights the ultimate benefit of a well-functioning pre-hospital to hospital chain.

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Section: Discussionmentioning

confidence: 99%

Complete embolization of a mechanical aortic valve during trail running—a case report with a lucky ending

Dalen

Graven

Slagsvold

et al. 2022

European Heart Journal - Case Reports

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“…In our case, CRP before starting antimicrobial treatment remained low between 0.94 and 3.46 mg/dL, and no leukocytosis was detected. Ribeyrolles et al [10] reported that CRP at admission was < 2 mg/dL in 13 (2.8%) of 469 patients with endocarditis. Not all patients with endocarditis present with elevated CRP or leukocytosis.…”

Section: Discussionmentioning

confidence: 99%

Blood culture–negative endocarditis caused by Bartonella henselae: a case report

Ohno

Saito

Iwata

et al. 2021

Indian J Thorac Cardiovasc Surg

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“…Furthermore, although the inflammatory markers wereslightly raised in our case, this did not influence our suspicion of IE. IE with low inflammatory markers is rare and can be encountered in immunocompromised patients and cases of IE caused by organisms such as Coxiella burnetii and Bartonella henselae [ 14 ]. Because our patient did not have immunodeficiency, the laboratory tests may be explained by the fastidious organism.…”

Section: Discussionmentioning

confidence: 99%

Confusion as an Unusual Presentation of Infective Endocarditis

Dabbous¹,

Saba²,

Orra³

et al. 2021

Cureus

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Infective endocarditis (IE) is a rare infection of the inner lining of the heart and valves, mainly affecting those with pre-existing heart problems. Patients usually present with fever and other non-specific systemic symptoms such as malaise, myalgia, and night sweats. However, IE may have unusual presentations, making its diagnosis even more challenging. Here, we report an unusual case of IE presenting as confusion.A 51-year-old man presented to the emergency department complaining of confusion for three days. Upon physical examination, there was an evident holosystolic murmur at the apex radiating to the axilla and an early decrescendo diastolic murmur at the left lower sternal border. Laboratory tests including white blood cell count and C-reactive protein were elevated. Transthoracic and transesophageal echocardiogram showed severe mitral regurgitation and aortic regurgitation, in addition to the presence of a mobile mass suspected to be vegetation on each of the mitral and aortic valves. Magnetic resonance imaging of the brain was performed which revealed ischemic lesions of possible embolic origin. Mitral and aortic valve replacement was performed successfully, and the patient recovered well.Our case emphasizes the possibility of unusual presentations in patients with IE, with confusion being one of them. It is important for physicians to always consider the diagnosis of IE in patients presenting with neurological symptoms of unclear origin.

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Infective endocarditis without biological inflammatory syndrome: Description of a particular entity

Cited by 12 publications

References 24 publications

Complete embolization of a mechanical aortic valve during trail running—a case report with a lucky ending

Complete embolization of a mechanical aortic valve during trail running—a case report with a lucky ending

Blood culture–negative endocarditis caused by Bartonella henselae: a case report

Confusion as an Unusual Presentation of Infective Endocarditis

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