Bivalvular infective endocarditis complicated by perivalvular abscess and aorto-right atrium fistula.
BMJ Case Rep
; 16(10)2023 Oct 29.
Article
en En
| MEDLINE
| ID: mdl-37899086
ABSTRACT
Infective endocarditis caused by Pseudomonas aeruginosa in patients without a history of intravenous drug abuse and endovascular procedures is rare. We present a middle-aged man with fever, chills, night sweats and dyspnoea for 2 weeks. Physical examination and blood cultures were drawn, and the patient was empirically started on antibiotics. Unfortunately, the patient experienced progressive clinical deterioration requiring endotracheal intubation and vasopressor support. Transthoracic echocardiogram followed by transesophageal echocardiogram was performed that showed bicuspid aortic valve, severe aortic regurgitation, membranous ventricular septal defect, vegetations on aortic and tricuspid valves, dilated aortic root, and a fistula between the aorta and right atrium. The patient underwent emergent aortic valve and aortic root replacement along with tricuspid commissuroplasty and ventricular septal defect (VSD) closure. Later, intraoperative tissue cultures grew P. aeruginosa, and antipseudomonal antibiotic coverage was added. This case highlights that P. aeruginosa endocarditis can occur without risk factors and can lead to fatal cardiovascular complications.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Endocarditis
/
Endocarditis Bacteriana
/
Fístula
/
Defectos del Tabique Interventricular
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
BMJ Case Rep
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos