Aortic and Tricuspid Endocarditis in Hemodialysis Patient with Systemic and Pulmonary Embolism

Aguiar Rosa, S; Germano, N; Santos, A; Bento, L

http://hdl.handle.net/10400.17/2349

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
Rev Bras Med Intens 2015.pdf		426.31 KB	Adobe PDF	Download

Send Feedback

Authors

Abstract(s)

This is a case report of a 43-year-old Caucasian male with end-stage renal disease being treated with hemodialysis and infective endocarditis in the aortic and tricuspid valves. The clinical presentation was dominated by neurologic impairment with cerebral embolism and hemorrhagic components. A thoracoabdominal computerized tomography scan revealed septic pulmonary embolus. The patient underwent empirical antibiotherapy with ceftriaxone, gentamicin and vancomycin, and the therapy was changed to flucloxacilin and gentamicin after the isolation of S. aureus in blood cultures. The multidisciplinary team determined that the patient should undergo valve replacement after the stabilization of the intracranial hemorrhage; however, on the 8th day of hospitalization, the patient entered cardiac arrest due to a massive septic pulmonary embolism and died. Despite the risk of aggravation of the hemorrhagic cerebral lesion, early surgical intervention should be considered in high-risk patients.

Keywords

HSM CAR CHLC UCI Anti-Bacterial Agents/therapeutic use Aortic Valve/microbiology Aortic Valve/pathology Endocarditis, Bacterial/drug therapy Endocarditis, Bacterial/microbiology Endocarditis, Bacterial/pathology Fatal Outcome Heart Arrest/etiology Heart Valve Diseases/drug therapy Heart Valve Diseases/microbiology Heart Valve Diseases/pathology Kidney Failure, Chronic/therapy Pulmonary Embolism/complications Pulmonary Embolism/microbiology Pulmonary Embolism/pathology Renal Dialysis/methods Staphylococcal Infections/drug therapy Staphylococcal Infections/microbiology Staphylococcal Infections/pathology Staphylococcus aureus/isolation & purification Tricuspid Valve/microbiology Tricuspid Valve/pathology