Acute Upper Limb Ischemia Suspected to Have Originated from Staphylococcus Epidermidis Native Valve Endocarditis / 대한내과학회지

ABSTRACT

We report a case of acute upper limb ischemia suspected to have originated from methicillin-resistant Staphylococcus epidermidis native valve endocarditis in a 57-year-old man who had complained of sudden-onset fever and pain in the right hand. 3D computed tomography of the right upper extremity detected a thrombus occluding the brachial artery. Echocardiography showed a large vegetation on the aortic valve. Thus, we suspected, clinically, brachial artery occlusion by septic emboli originating from a large vegetation of the aortic valve. The patient was treated with intravenous antibiotics for the suspected methicillin-resistant Staphylococcus epidermidis-native valve endocarditis with a combination of percutaneous aspiration thromboembolectomy and selective intra-arterial thrombolysis for acute thromboembolic occlusion in the right upper limb. The large vegetation of the aortic valve resolved without surgery and aortic regurgitation improved. The patient recovered uneventfully with no complications, including septic embolism, over the following 11 months.