Case Report
Natural progression of non-surgically managed infective endocarditis

https://doi.org/10.1016/j.jicc.2017.12.011Get rights and content

Abstract

This case depicts rarely seen images of infective endocarditis in a patient who was managed non-surgically. We present various echocardiograms which closely follow the progression the infective endocarditis in a patient with previous cardiac surgery and prosthetic material in situ.

A 51 year old gentleman presented presented with complaints of fevers and gastrointestinal infective symptoms in the context of previously having undergone an aortic root replacement and metallic aortic valve implantation several years prior for a previous episode of aortic dissection whilst utilising illicit intravenous drug use.

Echocardiography noted an aortic valve vegetation and blood cultures grew non typhoidal Salmonella Typhimurium. A surgical opinion deemed he was not an appropriate candidate for surgical intervention due to tissue friability and continuous intravenous drug use. Serial echocardiograms show the formation of an aortic root abscess, which fistulised between the left ventricle, right ventricle and right atrium. His clinical condition stabilised and was discharged from hospital with close community monitoring and life-long antibiotic therapy.

This case depicts the remarkable images surrounding the natural progression of infective endocarditis managed without surgical intervention, together with the difficulties and limitations in managing prosthetic valve endocarditis.

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Financial Assistance

There has been no financial support.

Responsibility for the Work

The conception, and writing of the submission has been performed and approved by the authors listed, with all parties involved in the care of the patient having been addressed prior to initial submission of the article. The article has been carefully constructed to include important intellectual content.

Conflict of Interest

The authors have none to declare.

Prior Publication

This article is not currently awaiting review with any other journal at the present time.

Ethics Approval

This case did not require institutional approval or ethics committee approval.

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