Ng Choon S, Mohamad Shawal, Maskon Oteh
Department of Medicine, National University of Malaysia Medical Center, Kuala Lumpur, Malaysia. E-mail.
Saudi Med J. 2015 Jun;36(6):743-6. doi: 10.15537/smj.2015.6.11420.
Infective endocarditis could present with a plethora of signs and symptoms. Among the rarity of its presentation is acute confusion associated with neurological deficits, mimicking stroke especially in the young population. We report a case of a 33-year-old young man with acute right-sided hemiparesis and confusion 2 weeks after tooth extraction. The brain CT and MRI was consistent with new infarction on the left middle and anterior cerebral arteries' territory. Echocardiography unveiled the existence of posterior mitral valve leaflet vegetation. Blood culture grew Group B beta-haemolytic Streptococcus, sensitive to penicillin. Two weeks of intravenous gentamicin with 6 weeks of intravenous benzylpenicillin were administered. In this case report, we highlight the importance of recognition of infective endocarditis in a young patient presenting with cerebrovascular accident following tooth extraction.
感染性心内膜炎可表现出多种体征和症状。其表现罕见的情况之一是伴有神经功能缺损的急性意识模糊,酷似中风,尤其是在年轻人群中。我们报告一例33岁青年男性病例,该患者在拔牙后2周出现急性右侧偏瘫和意识模糊。脑部CT和MRI显示与左侧大脑中动脉和前动脉供血区新梗死灶相符。超声心动图显示二尖瓣后叶有赘生物。血培养结果为B组β溶血性链球菌生长,对青霉素敏感。给予两周静脉注射庆大霉素及六周静脉注射苄星青霉素治疗。在本病例报告中,我们强调了在拔牙后出现脑血管意外的年轻患者中识别感染性心内膜炎的重要性。