Kararmaz Aktaş Lütfiye, Yılmaz Emre, Çamcı Sencer, Üngör Şeyma
Department of Cardiology, Giresun University, Giresun, TUR.
Cureus. 2025 Jul 24;17(7):e88650. doi: 10.7759/cureus.88650. eCollection 2025 Jul.
Infective endocarditis (IE) is a public health problem that can present patients with complex clinical scenarios and carry a significant risk of mortality and morbidity. The ability of clinicians to analyze these complex clinical scenarios may be facilitated by the inclusion of relevant case reports and reviews in the literature. To this end, we sought to add this complex case report to the literature. A 77-year-old man presented to the emergency department with a fever and widespread body pain, particularly in his chest, lower back, and buttocks. Initial investigations did not reveal any signs of IE. However, after ruling out other possible diagnoses, spondylodiscitis was detected via repeat lumbar magnetic resonance imaging. Methicillin-sensitive was identified in the control blood culture, and vegetation was identified in the control cardiac imaging. Although laboratory and imaging findings cannot make a definitive diagnosis of IE in the early stages, repeated examinations can reach a definitive diagnosis in suspected cases. Therefore, clinicians should always consider endocarditis in patients with elevated acute-phase reactants and a clinical presentation suggestive of vascular or embolic phenomena.
感染性心内膜炎(IE)是一个公共卫生问题,它会给患者带来复杂的临床情况,并伴有显著的死亡和发病风险。文献中纳入相关病例报告和综述可能有助于临床医生分析这些复杂的临床情况。为此,我们试图将这份复杂的病例报告补充到文献中。一名77岁男性因发热和全身广泛疼痛,尤其是胸部、下背部和臀部疼痛,前往急诊科就诊。初步检查未发现感染性心内膜炎的任何迹象。然而,在排除其他可能的诊断后,通过重复腰椎磁共振成像检测到了脊椎椎间盘炎。在对照血培养中鉴定出对甲氧西林敏感的细菌,在对照心脏成像中发现了赘生物。虽然实验室和影像学检查结果在早期不能确诊感染性心内膜炎,但重复检查可以在疑似病例中得出明确诊断。因此,临床医生在急性期反应物升高且临床表现提示血管或栓塞现象的患者中应始终考虑心内膜炎。