Department of Radiology, Insubria University, Varese, Italy.
Neurology and Stroke Unit, François Quesnay, Mantes-la-Jolie, France.
Interv Neuroradiol. 2022 Apr;28(2):142-144. doi: 10.1177/15910199211021716. Epub 2021 May 29.
Acute ischemic stroke (AIS) is the most common neurologic complication of infective endocarditis. We describe a singular case report of a 62- year-old male with AIS related to the occlusion of the left middle cerebral artery. Thrombus-aspiration allowed retrieving a 6 millimeters white thrombus. The real-time polymerase chain reaction performed on the thrombus detected Coxiella Burnetii allowed the diagnosis of infective endocarditis (IE) and the identification of the specific pathogen. Coxiella Burnetii is an endemic, small, intracellular, gram-negative coccobacillus and it is a rare cause of IE. The management of AIS caused by IE remains controversial, although in the cases of major occlusion mechanical thrombectomy is associated with better clinical outcomes. IE patients could not present symptoms and signs related to the infection, therefore we underline the importance of the microbiological analysis of the retrieved thrombi especially when atypical etiology is suspected.
急性缺血性脑卒中（AIS）是感染性心内膜炎最常见的神经并发症。我们报告了 1 例 62 岁男性 AIS 的病例，其病因与左大脑中动脉闭塞有关。血栓抽吸术取出了 6 毫米长的白色血栓。对血栓进行的实时聚合酶链反应检测到了柯克斯体，从而明确了感染性心内膜炎（IE）的诊断，并鉴定出了特定病原体。柯克斯体是一种地方性、小、细胞内、革兰阴性球杆菌，是 IE 的罕见病因。IE 引起的 AIS 的治疗仍存在争议，尽管在主要闭塞的情况下，机械血栓切除术与更好的临床结局相关。IE 患者可能没有与感染相关的症状和体征，因此我们强调对取出的血栓进行微生物分析的重要性，特别是在怀疑非典型病因时。
