RESUMO
Introduction: Spontaneous splenic rupture is an extremely rare complication of infective endocarditis. Case Report: We present a case of a 56-year-old immunocompetent female with porcine bioprosthetic mitral valve replacement, automated implanted cardioverter-defibrillator, and atrial fibrillation on apixaban who was found to have in-hospital atraumatic splenic rupture complicating infective endocarditis with Haemophilus parainfluenza. The rupture was treated successfully by endovascular embolization. Usual treatment with six weeks of antibiotics provided durable cure without further complication, and no surgical intervention was needed for either the valve or spleen. Conclusion: Transcatheter arterial embolization should be considered early in atraumatic splenic rupture. Relevant abdominal and cerebral imaging should be considered in all cases of suspected or confirmed infective endocarditis where unexplained symptoms are present.
RESUMO
Vertebral osteomyelitis is a rare clinical condition accounting for 1%-7% of all bone-related infections. The increase in chronic diseases such as diabetes mellitus or those that lead to immunosuppression, the increase in spinal instrumentation including epidural catheters for pain management, and the continual increase in intravenous (IV) drug use are factors that have led to the rise in cases. The condition may present subtly without clinical signs and symptoms making early diagnosis difficult. Here, we present a rare case of spontaneous osteodiscitis of the cervical spine complicated by epidural abscess/phlegmon, burst fracture, and spinal cord injury due to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in a patient with a history of intravenous drug use who presented with neck pain. The patient was treated with IV antibiotics and decompressive surgery and, however, was unable to regain the mobility of the lower extremities and regained only slight mobility in the upper extremities leading to an ultimate diagnosis of functional quadriplegia.