Abstract
Despite the medical and surgical advancements in the treatment of patients with acute infective endocarditis (IE), neurologic complications remain problematic. They can arise through various mechanisms consisting of stroke or transient ischemic attack, cerebral hemorrhage, mycotic aneurysm, meningitis, cerebral abscess, or encephalopathy. Most complications occur early during the course of IE and are characteristic to left-sided pathology of native or prosthetic valves. We present a case of a 46 year old male patient who presented to our clinic with mitral valve IE caused by coagulase negative staphylococcus. Although under correct antibiotic treatment, he continued to be feverish and started to present unspecific neurological symptoms (amnesia, confusion, asthenia and general malaise). The cerebral magnetic resonance imaging (MRI) revealed multiple cerebral abscesses. Because the patient was hemodynamically stable we decided to address the cerebral abscess first and the cardiac lesion second. The patient made a full recovery after undergoing antibiotic treatment and surgical procedures of drainage of the cerebral abscess and mitral valve replacement. After reviewing the literature regarding the management of patients with IE and cerebral complications and based on this particular case, we conclude that in select cases of stable patients with cerebral abscess and IE, the neurological lesion should always be addressed first and cardiac surgery should be performed second.
Keywords: Cardiac surgery, cerebral abscess, endocarditis, neurological complications, neurosurgery, valve replacement.
CNS & Neurological Disorders - Drug Targets
Title:Drainage of Cerebral Abscesses Prior to Valve Replacement in Stable Patients with Acute Left-Sided Infective Endocarditis
Volume: 14 Issue: 4
Author(s): Adrian Molnar, Ruxandra Beyer, Stefan Florian, Dafin F. Muresanu, Catalin Trifan, Ioan Muresan, Diana Sacui, Traian Scridon and Radu N. Balanescu
Affiliation:
Keywords: Cardiac surgery, cerebral abscess, endocarditis, neurological complications, neurosurgery, valve replacement.
Abstract: Despite the medical and surgical advancements in the treatment of patients with acute infective endocarditis (IE), neurologic complications remain problematic. They can arise through various mechanisms consisting of stroke or transient ischemic attack, cerebral hemorrhage, mycotic aneurysm, meningitis, cerebral abscess, or encephalopathy. Most complications occur early during the course of IE and are characteristic to left-sided pathology of native or prosthetic valves. We present a case of a 46 year old male patient who presented to our clinic with mitral valve IE caused by coagulase negative staphylococcus. Although under correct antibiotic treatment, he continued to be feverish and started to present unspecific neurological symptoms (amnesia, confusion, asthenia and general malaise). The cerebral magnetic resonance imaging (MRI) revealed multiple cerebral abscesses. Because the patient was hemodynamically stable we decided to address the cerebral abscess first and the cardiac lesion second. The patient made a full recovery after undergoing antibiotic treatment and surgical procedures of drainage of the cerebral abscess and mitral valve replacement. After reviewing the literature regarding the management of patients with IE and cerebral complications and based on this particular case, we conclude that in select cases of stable patients with cerebral abscess and IE, the neurological lesion should always be addressed first and cardiac surgery should be performed second.
Export Options
About this article
Cite this article as:
Molnar Adrian, Beyer Ruxandra, Florian Stefan, F. Muresanu Dafin, Trifan Catalin, Muresan Ioan, Sacui Diana, Scridon Traian and N. Balanescu Radu, Drainage of Cerebral Abscesses Prior to Valve Replacement in Stable Patients with Acute Left-Sided Infective Endocarditis, CNS & Neurological Disorders - Drug Targets 2015; 14 (4) . https://dx.doi.org/10.2174/1871527314666150317224921
DOI https://dx.doi.org/10.2174/1871527314666150317224921 |
Print ISSN 1871-5273 |
Publisher Name Bentham Science Publisher |
Online ISSN 1996-3181 |
Call for Papers in Thematic Issues
Diagnosis and treatment of central nervous system infectious diseases
Infectious diseases of the central nervous system (CNS) can be divided into bacterial, tuberculous, viral, fungal, parasitic infections, etc. Early etiological treatment is often the most crucial means to reduce the mortality rate of patients with central nervous system infections, reduce complications and sequelae, and improve prognosis. The initial clinical ...read more
Techniques of Drug Repurposing: Delivering a new life to Herbs & Drugs
Of late, with the adaptation of innovative approaches and integration of advancements made towards medical sciences as well as the availability of a wide range of tools; several therapeutic challenges are being translated into viable clinical solutions, with a high degree of efficacy, safety, and selectivity. With a better understanding ...read more
Trends and perspectives in the rational management of CNS disorders
Central nervous system (CNS) diseases enforce a significant global health burden, driving ongoing efforts to improve our understanding and effectiveness of therapy. This issue investigates current advances in the discipline, focusing on the understanding as well as therapeutic handling of various CNS diseases. The issue covers a variety of diseases, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Cardiovascular Diseases in Pregnancy - A Brief Overview
Current Cardiology Reviews Current Status of Newer Antiinfectives
Recent Patents on Anti-Infective Drug Discovery A Brief Overview of Antimicrobial Peptides Containing Unnatural Amino Acids and Ligand-Based Approaches for Peptide Ligands
Current Topics in Medicinal Chemistry Acute Cardioembolic Cerebral Infarction: Answers to Clinical Questions
Current Cardiology Reviews Hybrid Drugs as Potential Combatants Against Drug-Resistant Microbes: A Review
Current Topics in Medicinal Chemistry Hybrid Viral Vectors for Vaccine and Antibody Production in Plants
Current Pharmaceutical Design Macrophage Heterogeneity: Relevance and Functional Implications in Atherosclerosis
Current Vascular Pharmacology The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020
Current Pharmaceutical Biotechnology Toll-Like Receptors in Skin Infections and Inflammatory Diseases
Infectious Disorders - Drug Targets Heart Failure in South America
Current Cardiology Reviews <i>In Vitro</i> Evaluation of Immunogenicity of Recombinant OMP25 Protein Obtained from <i>Endemic Brucella</i> abortus Biovar 3 as Vaccine Candidate Molecule Against Animal Brucellosis
Protein & Peptide Letters The Deadly Quartet (Covid-19, Old Age, Lung Disease, and Heart Failure) Explains Why Coronavirus-Related Mortality in Northern Italy Was So High
Current Cardiology Reviews Role of Bone Marrow in the Pathogenesis of Rheumatoid Arthritis
Current Rheumatology Reviews The Human Microbiome Project, Personalized Medicine and the Birth of Pharmacomicrobiomics
Current Pharmacogenomics and Personalized Medicine Rheumatoid Nodulosis in a Patient with Lupus Erythematosus: Case Report and Review
Current Rheumatology Reviews Scintigraphic Imaging of Inflammatory Processes
Medicinal Chemistry Reviews - Online (Discontinued) Prevention of Bioprosthetic Heart Valve Calcification: Strategies and Outcomes
Current Medicinal Chemistry Development and Validation of a UV-Spectrophotometric Method for Determination of Flucloxacillin Sodium in Capsules
Current Pharmaceutical Analysis Chest Pain in Children
Current Pediatric Reviews The Rise of Carbapenem-Resistant Acinetobacter baumannii
Current Pharmaceutical Design