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J Card Surg 2021 Jun 10. Epub 2021 Jun 10.

Department of Infectious Disease Medicine, Fukuoka Red Cross Hospital, Fukuoka, Japan.

Lemierre's syndrome (LS) is characterized by septic thrombophlebitis of the internal jugular vein with septicemia and metastatic infection following an oropharyngeal infection. LS is rare but can cause infective endocarditis (IE), complicating IE management. We report a case of IE secondary to thrombophlebitis in the left vertebral vein following pharyngitis (LS variant) with distinctively severe manifestations, including metastatic infection and severe neurological impairment with multiple cerebral infarctions. Read More

Am J Case Rep 2021 May 14;22:e931376. Epub 2021 May 14.

Department of Infectious Disease, Rockledge Regional Medical Center, Rockledge, FL, USA.

BACKGROUND Convexal subarachnoid hemorrhage (cSAH), a rare form of non-aneurysmal subarachnoid hemorrhage, is confined to cerebral convexities without extension into basal cisterns or ventricles. Typical presentation includes thunderclap/progressive headache or transient focal neurological symptoms; rare manifestations include seizures, intractable vomiting, or altered mental status. Here, we report the first case of convexal subarachnoid hemorrhage and multifocal ischemic lesions caused by infective endocarditis (IE) in a treatment-naïve advanced HIV patient. Read More

Arch Cardiovasc Dis 2021 Apr 29. Epub 2021 Apr 29.

AP-HM, La Timone Hospital, Cardiology Department, 13005 Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, 13005 Marseille, France. Electronic address:

Background: Infective endocarditis (IE) is associated with a high mortality rate, related in part to neurological complications. Studies suggest that valvular surgery should be performed early when indicated, but is often delayed by the presence of neurological complications.

Aim: To assess the effect of delaying surgery in patients with IE and neurological complications and to identify factors predictive of death. Read More

Semin Neurol 2021 Apr 13. Epub 2021 Apr 13.

Department of Neurology, Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.

Infective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. Read More

Am J Case Rep 2021 Mar 13;22:e930561. Epub 2021 Mar 13.

Department of Cardiology, Botucatu Medical School - UNESP, São Paulo State University, Botucatu, SP, Brazil.

BACKGROUND Primary cardiac tumors represent less than 5% of total cardiac tumors. Fibroelastoma is a rare benign cardiac tumor that is usually asymptomatic but is acknowledged for its emboligenic potential for causing cardiac, neurological, and vascular symptoms and increasing patient morbidity and mortality. CASE REPORT This report describes the clinical case of a 27-year-old woman who entered the Emergency Department with motor aphasia and hemiparesis in the right dimidium. Read More

J Infect Public Health 2021 Jan 17;14(1):39-41. Epub 2020 Dec 17.

Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing 400037, China. Electronic address:

Infective endocarditis (IE) usually presents with nonspecific signs and symptoms, which delay diagnosis and proper treatment. Here, we describe a patient with initial clinical and radiological features compatible with neurocysticercosis who was later found to have IE. Furthermore, the patient course was complicated by multiple neurological complications (brain abscess, meningitis, infected intracranial aneurysm, subarachnoid hemorrhage and hemorrhage), and patient ultimately deceased. Read More

J Neurol 2020 Oct 3;267(10):2971-2982. Epub 2020 Jun 3.

Department of Radiology, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.

Aim: To assess: (1) the prevalence of convexity subarachnoid hemorrhage (cSAH) in infective endocarditis (IE); (2) its relationship with IE features; (3) the associated lesions; (4) whether cSAH is a predictor of future hemorrhage; (5) whether cSAH could cause cortical superficial siderosis (cSS).

Methods: We retrospectively evaluated the MRI data in 240 IE-patients: At baseline, the location of cSAH and associated lesions; at follow-up, the occurrence of new lesions and of cSS. Patients with and without cSAH were compared. Read More

Europace 2020 07;22(7):1062-1070

Department of Cardiology, Hospital General Universitario Gregorio Marañón, CIBERCV, Calle Doctor Esquerdo, 46, 28007 Madrid, Spain.

Aims: Patients with infective endocarditis (IE) frequently have cardiac implantable electronic devices (CIEDs). Here, we aim to define the clinical profile and prognostic factors of IE in these patients.

Methods And Results: Infective endocarditis cases were prospectively identified in the Spanish National Endocarditis Registry. Read More

J Clin Lab Anal 2020 May 3;34(5):e23206. Epub 2020 Feb 3.

Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.

Background: Ischemic stroke is one of the most prominent and serious neurological complications of infective endocarditis (IE). Our study was designed to evaluate the predictive value of higher level of plasma D-dimer on admission for the development of ischemic stroke in patients with IE.

Methods: In this prospective study, a total of 173 consecutive patients with IE were recruited from January 2016 to December 2018. Read More

Arch Argent Pediatr 2020 02;118(1):e22-e25

Department of Cardiovascular Surgery. Selcuk University Faculty of Medicine, Konya, Turkey.

Infective endocarditis (IE) is a rare but a potentially life-threatening infectious disease. Atypical presentations cause delays in the diagnosis. Neurological involvement such as meningitis or meningismus, are especially common in mitral valve endocarditis, but unusual in tricuspid valve endocarditis. Read More

J Neurointerv Surg 2020 Feb 14;12(2):e1. Epub 2020 Jan 14.

Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

Mycotic aneurysms (MA) are an uncommon complication of infectious endocarditis. Septic emboli are thought to be the precipitating event in their development, but the evidence for this is sparse. We present three cases in which septic embolic occlusion preceded MA development at the occlusion site, suggesting that documented angiographic emboli in patients with infectious endocarditis and bacteremia constitute a risk factor for MA formation. Read More

BMC Infect Dis 2019 Dec 18;19(1):1062. Epub 2019 Dec 18.

Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.

Background: To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand's largest national tertiary referral center.

Methods: Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed.

Results: Of 380 patients, 66. Read More

Ann Cardiothorac Surg 2019 Nov;8(6):661-666

Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Helios Clinic, Leipzig, Germany.

Background: Surgery is a common treatment option for patients with infective endocarditis. We present a large cohort of surgically managed patients with infective endocarditis and evaluate the long-term mortality of those with and without neurological complications.

Methods: We performed a retrospective review of patients surgically managed for infective endocarditis between 1994 and 2017. Read More

Eur Radiol 2020 Mar 11;30(3):1507-1516. Epub 2019 Nov 11.

Department of Radiology, Seoul National University Bundang Hospital, 82 Gumiro, 173 Beon-gil, Bundang-gu, Seongnamsi, Gyeonggi-do, 13620, Republic of Korea.

Objectives: To analyze the incidence and characteristics of intra-articular facet joint injection (FJI)-related adverse events requiring hospitalization and emergency room visits.

Methods: From January 2007 to December 2017, a total of 11,980 FJI procedures in 6066 patients (mean age 66.8 years, range 15-97 years, M:F = 2004:4062) were performed in our department. Read More

Semin Neurol 2019 08 18;39(4):495-506. Epub 2019 Sep 18.

Department of Neurology, Boston Medical Center, Boston, Massachusetts.

Infective endocarditis (IE) is a systemic disease with many potential neurologic manifestations including ischemic and hemorrhagic strokes, cerebral microbleeding, infectious intracranial aneurysms, meningitis, brain abscesses, and encephalopathy. The majority of left-sided (heart) IE patients have brain lesions that may alter management decisions, warranting the systematic use of magnetic resonance imaging. Many patients require surgical treatment of valvular disease, and central nervous system lesions weigh into decision making. Read More

Curr Neurol Neurosci Rep 2019 03 30;19(5):23. Epub 2019 Mar 30.

Department of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.

Purpose Of Review: The purpose of this narrative review and update is to summarize the current knowledge and provide recent advances on the neurologic complications of infective endocarditis.

Recent Findings: Neurological complications occur in about one-fourth of patients with infective endocarditis. Brain MRI represents a major tool for the identification of asymptomatic lesions, which occur in most of the patients with infective endocarditis. Read More

BMJ Case Rep 2019 Mar 20;12(3). Epub 2019 Mar 20.

Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.

First reported in 1988, is a virulent coagulase-negative species often associated with endocarditis. This is the first case report describing this infection in the cervical spine. A 58-year-old, left-handed Caucasian woman with no significant medical history presented with neck and left arm pain. Read More

Stroke 2019 04;50(4):e106-e109

Division of Allergy and Infectious Diseases (M.A.C.), Department of Medicine, University of Washington School of Medicine, Seattle.

Oper Neurosurg (Hagerstown) 2019 11;17(5):E224-E228

Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Background And Importance: Flow diversion of intracranial aneurysms has been rarely described in the pediatric population. Here we discuss the technical and perioperative complexities inherent in the flow diversion of an infectious basilar apex aneurysm in a 2-yr-old child with significant medical comorbidities.

Clinical Presentation: Following judicious oral administration of dual anti-platelet agents and intra-arterial administration of calcium channel blockers to treat vasospasm, standard endovascular procedures were used to place a flow diverting stent across the neck of a rapidly enlarging infectious aneurysm of the basilar apex. Read More

Ann Cardiol Angeiol (Paris) 2019 Apr 23;68(2):87-93. Epub 2019 Jan 23.

Service de cardiologie B, centre hosipitalier universitaire Ibn Sina, Rabat, Maroc.

Infective endocarditis is a grave disease because of a high level of morbidity and mortality. We conducted a retrospective analysis of 100 patients hospitalized for infective endocarditis from January 2009 until December 2015. The mean age was 41 years with a male predominance. Read More

Quant Imaging Med Surg 2018 Nov;8(10):1039-1051

Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.

Cerebrovascular complications may occur in infectious diseases in the setting of infective endocarditis, central nervous system (CNS) infections, systemic bacteremia and sepsis. Cerebrovascular complications of infections include vasculitis, mycotic aneurysms, and thrombophlebitis. Infectious vasculitis of the CNS may cause cerebral hemorrhage, infarction or ischemia. Read More

Neurocrit Care 2019 06;30(3):658-665

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

Background: The radiographic appearance of infectious intracranial aneurysms (IIAs) of infective endocarditis (IE) on magnetic resonance imaging (MRI) of brain is varied. We aimed to describe the IIA-specific MRI features in a series of patients with IIAs.

Methods: Records of patients with active IE who had digital subtraction angiography (DSA) at a tertiary medical center from January 2011 to December 2016 were reviewed. Read More

Pan Afr Med J 2018 27;30:184. Epub 2018 Jun 27.

Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction, Rabat, Maroc.

The diagnosis of splenic infarction is rarely reported in pregnant women. Current incidence of splenic infarction, especially during infectious endocardites as well as diagnostic methods used are poorly specified in the literature. We here report the case of a 26-year old woman with no particular previous history or cardiovascular risk factor who, at the end 14 weeks of amenorrhea, presented to the Emergency Department with febrile syndrome evolving over 10 days and abdominal pain of recent onset at the level of the left hypochondre. Read More

World Neurosurg 2019 Feb 14;122:429-432. Epub 2018 Nov 14.

Department of Neurosurgery, Kurashiki Central Hospital, Okayama, Japan.

Background: Distal middle cerebral artery aneurysm (DMCAAn) is rare, and the clinical features and the etiology are not well understood. Segmental artery mediolysis (SAM) is a pathologic entity that affects the media of the muscular artery and can cause arterial dissection and a hemorrhagic event. Subarachnoid hemorrhage (SAH) due to SAM in the vertebral artery has been documented. Read More

Ann Cardiol Angeiol (Paris) 2019 Apr 6;68(2):94-97. Epub 2018 Oct 6.

Faculté de médecine, Oran, Algérie.

Introduction: Infectious endocarditis (IE) is a serious disease that has continued to evolve in diagnostic and therapeutic terms.

Aim: To analyze the diagnostic and out come profile.

Methods: We collected 57 (IE) cases with a definite diagnosis according to the modified Duke criteria. Read More

BMJ Case Rep 2018 Sep 10;2018. Epub 2018 Sep 10.

Department of Internal Medicine, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.

We present an interesting case of late-onset intracranial bleeding (ICB) as a complication of causing infective endocarditis. A previously healthy young woman was diagnosed with infective endocarditis. While she was already on treatment for 2 weeks, she had developed seizures with a localising neurological sign. Read More

Childs Nerv Syst 2019 01 20;35(1):165-168. Epub 2018 Aug 20.

Neurosurgery Department, Fann Teaching Hospital, Dakar, Senegal.

Objective: The aim of this study is to show the characteristics of pediatric intracranial aneurysms in a sub-Saharan country and to analyze the results of treatment in this challenging medical environment.

Method: The authors reviewed retrospectively ten patients ≤ 18 years old between May 2013 and December 2016 in Neurosurgery department of Fann Hospital in Dakar. For each child, clinical features, radiological findings, and outcome were determined with mean follow-up of 22 months. Read More

World Neurosurg 2018 Oct 17;118:e813-e817. Epub 2018 Jul 17.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Introduction: Infectious intracranial aneurysms (IIAs) are a rare but potentially devastating complication of infective endocarditis. The clinical and radiographic findings that predispose patients to IIA remain poorly understood.

Methods: We performed a retrospective review of a prospectively maintained database of consecutive endocarditis patients undergoing catheter-based angiography at a single tertiary-level academic center during the period of July 2013-December 2017. Read More

Cureus 2018 Apr 12;10(4):e2469. Epub 2018 Apr 12.

Division of Cardiology, Brooklyn Hospital Center/Mount Sinai Hospital, New York, USA.

Infective endocarditis (IE) secondary to Staphylococcus lugdunensis has been increasingly recognized since 1988. IE-related thromboembolism represents an associated complication of the disease and carries a dismal prognosis. However, the incidence of cerebrovascular accident secondary to S. Read More

Can J Cardiol 2018 06 31;34(6):759-765. Epub 2018 Jan 31.

Department of Cardiac Surgery, Montreal Heart Institute, Université de Montreal, Montreal, Québec, Canada. Electronic address:

Background: Although the Ross procedure offers potential benefits in young adults, technical complexity represents a significant limitation. Therefore, the safety of expanding its use in more complex settings is uncertain. The aim of this study was to compare early outcomes of standard isolated Ross procedures vs expanding elgibility to higher-risk clinical settings. Read More