Aguiar Rosa, SGermano, NSantos, ABento, L2015-12-032015-12-032015Rev Bras Ter Intensiva. 2015 Apr-Jun;27(2):185-9http://hdl.handle.net/10400.17/2349This 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.engHSM CARCHLC UCIAnti-Bacterial Agents/therapeutic useAortic Valve/microbiologyAortic Valve/pathologyEndocarditis, Bacterial/drug therapyEndocarditis, Bacterial/microbiologyEndocarditis, Bacterial/pathologyFatal OutcomeHeart Arrest/etiologyHeart Valve Diseases/drug therapyHeart Valve Diseases/microbiologyHeart Valve Diseases/pathologyKidney Failure, Chronic/therapyPulmonary Embolism/complicationsPulmonary Embolism/microbiologyPulmonary Embolism/pathologyRenal Dialysis/methodsStaphylococcal Infections/drug therapyStaphylococcal Infections/microbiologyStaphylococcal Infections/pathologyStaphylococcus aureus/isolation & purificationTricuspid Valve/microbiologyTricuspid Valve/pathologyjournal article10.5935/0103-507X.20150031