Abiotrophia defectiva Endocarditis Complicated by Stroke and Spinal Osteomyelitis.

A 67-year-old male with coronary artery disease and aortic stenosis after coronary artery bypass graft (CABG) and aortic valve replacement (AVR) presented after a two-day history of dizziness and frequent falls. Initially, he was found to have a subacute infarct of the left temporal lobe, osteomyelitis of the lumbar spine, and an aortic valve vegetation. Further investigations demonstrated gram-positive bacteremia, and, eventually, the causative organism was identified as Abiotrophia defectiva. He was treated with penicillin and gentamicin in the inpatient setting and then discharged with outpatient intravenous (IV) ceftriaxone for the remainder of the four-week antibiotic course. He did not suffer complications after initiating therapy and recovered. We wish to raise awareness of the existence and complications that can result from A. defectiva endocarditis and encourage further research into effective antibiotic treatment. A. defectiva endocarditis may lead to neurological and orthopedic infective sequelae; understanding and awareness of Abiotrophia spp. infections are important to ensure effective treatment of endocarditis.

Ludwig's Angina and Treatment Considerations in the COVID-19 Pandemic.

Introduction: Ludwig's angina is a type of severe cellulitis that spreads rapidly and carries a significant risk of airway compromise. Previous complications with COVID-19 are poorly described within the literature. Case Presentation: This case report describes the complication of COVID-19 infection with suspected Ludwig's angina 2 days after admission, resulting in awake fibroscopic endotracheal intubation. Emergent treatment and establishing a secure airway are paramount in these cases. We discuss the role of antibiotics and adjunct treatment in these cases of potential airway compromise. Conclusion: Limited data demonstrate simultaneous infection of COVID-19 with these types of submandibular soft tissue infections in the literature. Previous explorations into this subject are limited, as COVID-19 is a relatively new condition with its own treatment guidelines. We discuss specifically the role of corticosteroid use and surgical intervention in these cases. We wish to highlight awareness and treatment considerations for COVID-19 patients with superimposed Ludwig's angina.

Pheochromocytoma and Hypertrophic Cardiomyopathy Leading to Cardiac Arrest.

A 33-year-old female with no known past medical history presented to the hospital for a witnessed cardiac arrest. The patient was emergently intubated and sedated. Further investigation demonstrated an 8.5 cm x 7.6 cm mass in the adrenal region, which was subsequently found to be a pheochromocytoma by biopsy. She was transferred to a tertiary care center for further evaluation. We wish to raise awareness of this condition among clinicians and encourage further research into the connections between pheochromocytoma and further cardiac complications.

Left Atrial Myxoma With Aortic Insufficiency Leading to Cerebrovascular Accident.

Primary cardiac tumors are extremely rare and can lead to significant neurologic symptoms if not diagnosed and treated appropriately. Cardiac myxomas represent the most common subtype of cardiac tumors and are typically located on the left side of the heart and, when diagnosed appropriately with echocardiography, are typically treated with surgical excision. Simultaneous presentation of myxoma and valvular insufficiency is rare and under-documented. This is a rare case of a patient with a left atrial myxoma and aortic insufficiency leading to cerebrovascular symptoms.

Lazarus Syndrome After Aortic Aneurysm Repair.

Introduction: Lazarus syndrome is defined as the spontaneous return of circulation after cessation of cardiopulmonary resuscitation (CPR). Though there have been multiple cases of Lazarus syndrome documented in the literature, it is a significantly underreported phenomenon with less than 100 cases reported in the literature since the first case in 1982. Case Presentation: After elective aortic aneurysm repair, an 88-year-old with a do-not-resuscitate directive had cardiac arrest, briefly showing post-mortem respiration and pulse. Despite resuscitation efforts including pharmacological intervention and CPR, he passed away within an hour. This case highlights complexities in end-of-life care and warrants exploration of post-mortem physiological responses. Conclusion: The Lazarus phenomenon, rare post-CPR circulation return, challenges resuscitation cessation. Our case, among the oldest, highlights extended monitoring necessity, especially in chronic obstructive pulmonary disease patients. Debate persists on monitoring duration after failed CPR, lacking established Lazarus syndrome prevention guidelines.