A case of infective endocarditis with the manifestation of multi-organ embolisms: a case report.

Abstract

Background: Infective endocarditis (IE) is a complex and life-threatening condition in clinical practice. It is important for the clinical management of IE to make a timely and accurate diagnosis and to actively implement appropriate treatment plans.

Medical history summary: The patient was a 60-year-old man who was admitted to our hospital on 31 January 2016. On admission, he had a temperature of 38.9°C; the breath sounds in both lungs were coarse, and no obvious dry and wet rales were heard. Rapid rate atrial fibrillation, small amounts of aortic, mitral and tricuspid valve regurgitation and arrhythmia were observed. On 2 February 2016, cranial magnetic resonance imaging showedmultiple acute infarct foci in the right frontoparietal lobe, corpus callosum knee and both cerebellar hemispheres. The diagnostic results were cerebral infarction, atrial fibrillation and acute coronary syndrome. The patient was given 200 mg aspirin tablets to take orally once a day, 20 mg Atorvastatin calcium tablets to take orally once at night and a 30 mg Edaravone injection to administer twice daily. On 3 February 2016, blood culture was positive for Staphylococcus aureus. A vancomycin injection of 500 mg was administered twice a day for anti-infection treatment. On 7 February 2016, the patient went to another hospital. On 6 March 2016, he returned to our hospital due to recurrent chest tightness and shortness of breath, where he underwent an ultrasound examination of his heart on 14 March 2016 and was diagnosed with IE.

Conclusion: Attention should be paid to the recent appearance of or changes concerning atrial fibrillation or cardiac murmur in patients with a history of cardiac disease and a lack of risk factors for stroke. For patients with cerebral infarction and positive blood culture but where no vegetation was observed via cardiac ultrasound, follow-up procedures should be strengthened after discharge.