Septic Embolism in a Patient with Infective Endocarditis and COVID-19

Dias, Camila Negreiro; Farias, Luís Arthur Brasil Gadelha; Cavalcante, Francisco J.

doi:10.4269/ajtmh.20-1133

Cited by 13 publications

(11 citation statements)

References 3 publications

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“…Twenty-one cases from 20 publications that satisfied inclusion criteria were identified 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ( Figure 1 ). There were 8 cases in the United States, 7 in Europe (Italy 3, Spain 2, United Kingdom 1 and Greece 1), 3 in the Middle East (Iran, Morocco, Tunisia), 2 in South America (Brazil and Ecuador), and 1 in Asia (Indonesia).…”

Section: Resultsmentioning

confidence: 99%

A clinical profile of infective endocarditis in patients with recent COVID-19: A systematic review

Quintero-Martinez

Hindy

Mahmood

et al. 2022

The American Journal of the Medical Sciences

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Section: Resultsmentioning

confidence: 99%

A clinical profile of infective endocarditis in patients with recent COVID-19: A systematic review

Quintero-Martinez

Hindy

Mahmood

et al. 2022

The American Journal of the Medical Sciences

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“…3 A case report in Brazil discussed a patient who presented with septic emboli and was diagnosed with IE and COVID-19. 4 Since these case reports, there have been few other reports published, but any association remains largely unknown.…”

Section: Discussionmentioning

confidence: 99%

Complex case of COVID-19 and infective endocarditis

2021

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A 50-year-old man with no medical history of note presented with new onset of confusion and dyspnoea. He tested positive for coronavirus (COVID-19), and subsequently, was admitted to the intensive care unit due to severe sepsis and acute renal failure requiring haemodialysis. Shortly afterwards, he was intubated due to haemodynamic instability. His blood culture was positive for Staphylococcus aureus bacteraemia, and echocardiogram showed evidence of vegetation in the aortic valve area. He was commenced on intravenous antibiotics for infective endocarditis (IE). Following extubation, he underwent an MRI of the spine due to increasing back pain. This was suggestive of L5–S1 discitis, likely secondary to septic emboli from IE. A few days later, he developed acute ischaemia of the left toes and extensive thrombosis of the right cubital and left iliac veins. Following a prolonged hospital admission, he was discharged home and later underwent an elective forefoot amputation from which he made a good recovery.

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“…A recent systematic review identified 15 cases of IE in the context of COVID-19 in patients aged 20 to 73 years, especially men, most cases of native valves, aortic position, and predominated etiology with Enterococcus faecalis [2]. Other confirmed etiologies were Methicillin-sensitive or Methicillin-resistant Staphylococcus spp., Pseudomonas aeruginosa, Candida albicans, but no case of Streptococcus gordonii was found [14][15][16][17]. The causative relationship of COVID-19 and IE was not proved until now and could be coincidental in the context of health care deficient organization during the pandemic [18].…”

Section: Discussionmentioning

confidence: 96%

A Challenge of COVID—19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient

et al. 2021

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The COVID-19 pandemic is a new challenge for the diagnosis and treatment of infective endocarditis (IE). Fever and other unspecific symptoms of coronaviral infection could be misleading or masking its manifestations. We present the case of a young patient admitted for persistent fever, profuse sweating, headache, articular pain, myalgias, and weight loss. She reported regression taste and smell disorders compared to a month earlier when diagnosed with moderate COVID-19 pneumonia. While the RT-PCR SARS-COV-2 test was positive, she was admitted to a COVID-19 ward. Investigations of febrile syndrome revealed two positive blood cultures with Streptococcus gordonii and the presence of vegetations on the aortic valve, supporting a certain diagnosis of IE. After six weeks of antibiotic treatment, the patient had clinical and biologic favorable outcomes. Streptococcus gordonii is a common commensal related to the dental biofilm, although there were no caries in our patient. The influence of COVID-19 infection on the human microbiome by modifying the virulence of some commensal germs may be a risk factor for IE pathogenesis on native valves and requires the vigilance of clinicians for suspicion of this disease.

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Septic Embolism in a Patient with Infective Endocarditis and COVID-19

Cited by 13 publications

References 3 publications

A clinical profile of infective endocarditis in patients with recent COVID-19: A systematic review

A clinical profile of infective endocarditis in patients with recent COVID-19: A systematic review

Complex case of COVID-19 and infective endocarditis

A Challenge of COVID—19: Associated Infective Endocarditis with Streptococcus gordonii in a Young Immunocompetent Patient

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