A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives

Tropical Medicine and Infectious Disease

article

Ali Shafeeq¹  Hisham Ahmed Imad²  Ahmed Azhad¹  Migdhaadh Shareef¹  Mohamed Shaneez Najmy¹  Mohamed Mausool Siraj¹  Mohamed Sunil¹  Rimsha Rafeeu⁵  Aishath Sofa Moosa⁵  Ahmed Shaheed⁶  Thundon Ngamprasertchai³  Wasin Matsee³  Pyae Linn Aung²  Wang Nguitragool²  Tatsuo Shioda⁴ 

[1] National Cardiac Center, Indira Gandhi Memorial Hospital;Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University;Thai Travel Clinic, Hospital for Tropical Diseases;Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University;Trauma and Emergency, Indira Gandhi Memorial Hospital;Department of Medicine, Indira Gandhi Memorial Hospital;Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University;Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University

关键词: infective endocarditis;    methicillin-resistant Staphylococcus aureus;    mitral valve;   

DOI  :  10.3390/tropicalmed8010053

学科分类：社会科学、人文和艺术（综合）

来源: mdpi

【 摘 要 】

Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.

【 授权许可】

CC BY