Work

Recurrent Systemic Embolization From Bicuspid Aortic Valve Endocarditis in the Setting of Anti-coagulation Use

Year: 2024

Type: article

Abstract: Infective endocarditis (IE) is a systemic disease with a high mortality rate even with intravenous antibiotic therapy. Abnormal valves, including bicuspid aortic valves (BAV), are particularly prone to it compared to normal valves. We present a 22-year-old female who was initially admitted for the management of acute splenic infarction when she was diagnosed with a bicuspid aortic valve. With no evidence of a cardiac source of the embolus, she was discharged on anti-coagulation. However, she returned with acute toe ischemia in a few days. She was found to have Streptococcus mitis bacteremia, multiple sub-centimeter aortic valve vegetations on trans-esophageal echocardiogram (TEE), and was subsequently diagnosed with IE. After 3 weeks of IV antibiotics, she presented with thalamic stroke. Our case underscores the challenges in managing IE, particularly in young patients with BAV. Early recognition and aggressive treatment, regardless of vegetation size, and avoidance of anti-coagulation are crucial to mitigate embolic complications.

Source: Cureus

DOI: 10.7759/cureus.73187

Authors: Soomal Rafique, Salvador Fernandez, Saliha Saleem, Sami Akram

Institution: SIU Medicine

Language: English

Topic: Infective Endocarditis Diagnosis and Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4404149287