Argudín Maria Angeles, Mzougui Samy, Frippiat Frédéric, Giot Jean-Baptiste, Infantino Vincent, Meex Cécile, Hayette Marie-Pierre, Bontems Sebastien, Zorzi Giulia, Scohy Anaïs, Rodriguez-Villalobos Hector, Kabamba Mukadi Benoît
Microbiology, Cliniques Universitaires Saint Luc - Université Catholique de Louvain, Brussels, BEL.
Medical Microbiology, Institute of Experimental and Clinical Research - Université Catholique de Louvain, Brussels, BEL.
Cureus. 2024 Dec 20;16(12):e76074. doi: 10.7759/cureus.76074. eCollection 2024 Dec.
is rarely associated with neurological manifestations. This report describes a rare case of endocarditis complicated by a cerebral stroke caused by . We also briefly reviewed the neurological clinical spectrum of disease described in the literature. Serology tests were performed using the VIRCLIA®-system (chemiluminescence assay, Vircell, Spain) and immunofluorescence assay (IFA; Focus Diagnostics, USA). Cerebrospinal fluid (CSF) was tested using the BioFire-CSF-FilmArray-Meningitis/Encephalitis Panel (bioMérieux, France). CSF, plasma, and biopsy samples were tested using -qPCR combined with Sanger-sequencing. A 23-year-old male Afghan refugee residing in Belgium presented with persistent fatigue and cough. A calcified aortic bicuspid with severe insufficiency and moderately associated stenosis was diagnosed. A transesophageal echocardiogram revealed a shrinking valve and a mobile mass attached to the calcification of the free edge at the aorta. He developed fever, a moderate inflammatory syndrome with normocytic anemia, and renal failure with hematuria and proteinuria, indicating probable glomerulonephritis. He met the Duke criteria for infective endocarditis, though blood cultures were initially negative. serology later returned positive. He developed a fever and intense headache. CSF showed moderate pleiocytosis, but a negative-FilmArray. Neurovascular MR-angiography revealed a multifocal ischemic stroke. His aortic valve was replaced (Ross procedure). The biopsy showed nodular and degenerative fibro-calcified rearrangements. presence was confirmed in CSF, blood, and mitral valve samples. Our report underlines that is a rare but a possible cause of endocarditis and neurological damage, and emphasizes the need for effective healthcare access, which is often limited in the countries of origin of migrants and even for migrants residing in high-resource countries.
很少与神经学表现相关。本报告描述了一例罕见的感染性心内膜炎并发脑卒病例，病因是……我们还简要回顾了文献中描述的……疾病的神经学临床谱。血清学检测使用VIRCLIA®系统（化学发光法，西班牙Vircell公司）和免疫荧光法（IFA；美国Focus Diagnostics公司）。脑脊液（CSF）检测使用BioFire-CSF-FilmArray-脑膜炎/脑炎检测板（法国生物梅里埃公司）。脑脊液、血浆和活检样本采用-qPCR结合桑格测序法进行检测。一名居住在比利时的23岁阿富汗男性难民出现持续疲劳和咳嗽症状。诊断为钙化性主动脉二叶瓣伴严重关闭不全和中度相关狭窄。经食管超声心动图显示瓣膜缩小，在主动脉游离缘钙化处有一个活动团块。他出现发热、伴有正细胞性贫血的中度炎症综合征以及伴有血尿和蛋白尿的肾衰竭，提示可能为肾小球肾炎。他符合感染性心内膜炎的杜克标准，尽管血培养最初为阴性。……血清学检测后来呈阳性。他出现发热和剧烈头痛。脑脊液显示中度细胞增多，但FilmArray检测为阴性。神经血管磁共振血管造影显示多灶性缺血性脑卒中。他接受了主动脉瓣置换术（罗斯手术）。活检显示结节性和退行性纤维钙化重排。在脑脊液、血液和二尖瓣样本中证实了……的存在。我们的报告强调，……是感染性心内膜炎和神经损伤的一种罕见但可能的病因，并强调需要获得有效的医疗服务，而这在移民原籍国往往有限，甚至对于居住在资源丰富国家的移民也是如此。
