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Images in Intensive Medicine
Complicated early prosthetic aortic valve infective endocarditis
Endocarditis infecciosa aórtica protésica precoz complicada
J.V. Catalá Ripolla,
Corresponding author
jose.catalaripoll@gmail.com

Corresponding author.
, C. Urraca Espejelb, P. Cuesta Monteroa
a Servicio de Anestesiología y Reanimación, Hospital General Universitario de Albacete, Albacete, Spain
b Servicio de Cardiología, Hospital General Universitario de Albacete, Albacete, Spain
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    "titulo" => "Complicated early prosthetic aortic valve infective endocarditis"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Sixty-six year-old patient with a mechanical aortic prosthesis implanted two months ago, who recently experienced a deterioration in his level of consciousness and a sudden-onset fever of up to 39<span class="elsevierStyleHsp" style=""></span>&deg;C, along with a bluish nodular lesion in the fifth digit (little finger) of his left hand. The brain CAT scan performed revealed a parietal intraparenchymal hemorrhage, of which blood cultures were taken (with a positive result for <span class="elsevierStyleItalic">Staphylococcus aureus</span>). Furthermore, the transthoracic echocardiogram (TTE) carried out showed a poorly differentiated hyperechogenic image at the level of the prosthetic valve. Based on the above findings, a transesophageal echocardiography (TEE) was also performed revealing the presence of a metallic aortic valve prosthesis associated with periaortic thickening (arrow, <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) along with images of cavitated lesions in the posterior end of the aortic root (asterisk, <a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), one of which was seen to come into contact with it, thus being suggestive of a complicated endocarditis. Additionally, a cardiac CAT scan showed a 9-mm heart wall defect coming into contact with a 9<span class="elsevierStyleHsp" style=""></span>&times;<span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>&times;<span class="elsevierStyleHsp" style=""></span>5.5-cm collection, as well as contrast media extravasation suggestive of a broken pseudoaneurysm contained by the epicardium (arrow, <a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). This case report brings to light the key role of TEE in detecting cases of endocarditis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>"
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Article information
ISSN: 21735727
Original language: English
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