Systemic Storm: Multi-Organ Septic Emboli in Acute Aortic Valve Endocarditis

Authors

Jilpa Shah, HCA HealthcareFollow
Akshaj Pole, HCA HealthcareFollow
Amnah Andrabi

Files

Division

North Texas

Hospital

Medical City Arlington

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2024

Keywords

infective endocarditis

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences

Abstract

According to the Infectious Disease Society of America (IDSA), Infective endocarditis (IE) is an infection of the endocardial surface of the native valve, prosthetic heart valve, or an implanted cardiac device such as a permanent pacemaker or a defibrillator. IE is a rare fatal disease with an incidence rate of 3 to 10 cases per 100,000 people, predominantly in males over the age of 50 years in developed countries. Septic emboli are a serious sequelae of infective endocarditis with commonly affecting brain, spleen, kidneys, and lung. Usually, initial management includes tapered long term antibiotics with surgical evaluation for possible valve replacement. Here, we present the case of an 80 year old male with no significant past medical history or known valvular abnormalities, who came in with generalized weakness and right sided abdominal pain. Patient was initially admitted for sepsis secondary to UTI and right sided hydroureteronephrosis. Blood and urine cultures were positive for Staphylococcus aureus, and Transthoracic echocardiogram revealed medium size vegetation on the aortic valve, thus, confirming the diagnosis of acute aortic valve infective endocarditis. Clinical course evolved into multiple septic emboli to nearly all vascular territories in the brain, splenic infarct, and acute limb ischemia. Unfortunately, the significant clot burden led to rapid clinical deterioration and ultimate demise of the patient. A brief literature search suggests the rarity of superimposed complications of IE in a single patient without significant risk factors. Early recognition and prompt surgical intervention is vital toward improving outcomes in patients with IE as perioperative risk can increase exponentially when delays arise in management.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Shah, Jilpa; Pole, Akshaj; and Andrabi, Amnah, "Systemic Storm: Multi-Organ Septic Emboli in Acute Aortic Valve Endocarditis" (2024). North Texas Research Forum 2024. 19.
https://scholarlycommons.hcahealthcare.com/northtexas2024/19