Hilker Eric, Patil Sachin M, Holliday Zach, Arora Niraj
Department of Medicine, University of Missouri School of Medicine, Columbia, USA.
Infectious Disease, University of Missouri, Columbia, USA.
Cureus. 2022 Feb 15;14(2):e22238. doi: 10.7759/cureus.22238. eCollection 2022 Feb.
Infective endocarditis (IE) is a severe infection of the endocardium and cardiac valves by multiple etiologic agents. Clinical presentation can be acute or subacute based on the host immunity and the causative agent's virulence. Although are responsible for most community-acquired native valve bacterial IE, is an infrequent cause. can rarely infect prosthetic cardiac valves. A middle-aged white male with poorly controlled type 2 diabetes mellitus was transferred to our facility for suspected stroke with an initial presentation of acute encephalopathy of uncertain duration. Transthoracic echocardiogram revealed a left ventricular apical mural vegetation, and brain imaging displayed multiple white matter hypodensities indicative of numerous small strokes. Blood cultures were positive for . Clinical presentation was unusual with an acute encephalopathy due to multiple septic emboli and primary mural IE with high-grade bacteremia due to . PubMed medical literature review reveals this to be a rare clinical presentation by an uncommon etiological agent with an infrequent echocardiogram finding.
感染性心内膜炎（IE）是由多种病原体引起的心内膜和心脏瓣膜的严重感染。根据宿主免疫力和病原体毒力，临床表现可为急性或亚急性。虽然 是大多数社区获得性天然瓣膜细菌性IE的病因，但 是罕见病因。 很少感染人工心脏瓣膜。一名中年白人男性，2型糖尿病控制不佳，因疑似中风被转至我院，最初表现为持续时间不确定的急性脑病。经胸超声心动图显示左心室心尖部壁上有赘生物，脑部成像显示多个白质低密度灶，提示有多处小中风。血培养 呈阳性。临床表现不寻常，因多个脓毒性栓子导致急性脑病，以及因 导致原发性壁性IE伴高度菌血症。PubMed医学文献综述显示，这是一种由罕见病原体引起的罕见临床表现，超声心动图表现也不常见。
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