Genç Yaşta İskemik İnmenin Nadir Bir Nedeni: İnfektif Endokardit

Year 2014, Volume: 5 Issue: 2, 60 - 62, 01.02.2014

Oğuz Urgan Serkan Emre Eroğlu Ömer Faruk Çelik Özge Ecmel Onur Arzu Denizbaşı

Abstract

Giriş: Tedavi edilmediğinde infektif endokardit neredeyse her zaman
ölümcül hastalıktır. Ateş, kardiyak üfürüm ve myalji, halsizlik
gibi nonspesifik semptomlar sıktır. Burada, ön tanısı menenjit olan
ve takibi sırasında inme gelişen infektif endokardit son tanılı bir
hasta sunulmaktadır.
Olgu Sunumu: On dokuz yaşında erkek hasta 10 gündür devam
eden yüksek ateş ve bilinç kapalılığı nedeniyle başvurdu. Sistemik
hastalığa sahip olmadığı bilinmekteydi. Solunum, genitoüriner,
gastrointestinal yolda ya da deride belirgin lezyonlara rastlanmadı.
Yine, fizik muayenede ense sertliği de yoktu. Menenjit açısından
takip edildiği sırada hastada sol hemiparezi (4/5) gelişti ve
kraniyal manyetik görüntüleme ile sağ MCA bölgesinde infarkt
saptandı. Neticede hastanın şikayetlerinin kaynağının infektif endokardit
olduğu tespit edildi.
Sonuç: Bu vaka sunumu, özellikle de genç hastalardaki sistemik
embolilerin etyolojisinde infektif endokarditin hatırlanması gerektiğini
vurgulamaktadır.

Keywords

Endokardit, emboli, inme

A Rare Cause of Ischemic Stroke in Young Age: Infective Endocarditis

Abstract

Introduction: If untreated, infective endocarditis is virtually always a fatal disease. Fever, cardiac soufflé, and nonspecific symptoms, such as myalgia and fatigue, are common. Here, we present a patient with the last diagnosis of infective endocarditis whose pre-diagnosis was meningitis and who developed stroke during the follow-up.Case Report: A 19-year-old male presented with a complaint of clouded consciousness and hyperthermia that he had experienced for 10 days. He was known to have no systemic disease. No obvious respiratory tract, genitourinary tract, gastrointestinal tract, or skin lesions were observed. Also, there was no neck stiffness on physical examination. He developed left hemiparesia (4/5) during the follow-up of the meningitis, and using cranial magnetic resonance, infarcts were found in the right MCA territories. After all, infective endocarditis was found as the origin of his complaints.Conclusion: This case report also emphasizes that we should not forget infective endocarditis in the etiology of systemic embolisms, especially in young patients

Keywords

Endocarditis, embolism, stroke

References

• Mylonakis E, Calderwood SB. Infective endocarditis in adults. N Engl J Med 2001; 345: 1318-30. [CrossRef]
• Homma S, Grahame-Clarke C. Toward reducing embolic complications from endocarditis. J Am Coll Cardiol 2003; 42: 781-3. [CrossRef]
• Steckelberg JM, Murphy JG, Ballard D, Bailey K, Tajik AJ, Taliercio CP, et. al. Emboli in infective endocarditis: the prognostic value of echocardiog- raphy. Ann Intern Med 1991; 114: 635-40. [CrossRef]
• Nissen H, Nielsen PF, Frederiksen M, Helleberg C, Nielsen JS. Native val- ve infective endocarditis in the general population: a 10-year survey of the clinical picture during the 1980s. Eur Heart J 1992; 13: 872-7.
• Berlin JA, Abrutyn E, Strom BL, Kinman JL, Levison ME, Korzeniowski, et. al. Incidence of infective endocarditis in the Delaware Valley, 1988- 1990. Am J Cardiol 1995; 76: 933-6. [CrossRef]
• Hart GH, Foster JW, Luther MF, Kanter MC. Stroke in infective endocardi- tis. Stroke 1990; 21: 695-700. [CrossRef]
• Kanemitsu S, Tanabe S, Ohue K, Miyagawa H, Miyake Y, Okabe M, et Al. Aortic valve destruction and pseudoaneurysm of the sinus of valsal- va associated with infective endocarditis. Ann Thorac Cardiovasc Surg 2010; 16: 142-4
• Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilai- nen P. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med 2000; 160: 2781-7. [CrossRef]
• Watanakunakorn C, Burket T. Infective endocarditis at a large commu- nity teaching hospital 1980-1990. A review of 210 episodes. Medicine 1993; 72: 90-102. [CrossRef]