2^nd Global Cardiology Summit

Biography

Biography: Joy K. Fongayao

Abstract

INTRODUCTION: Multiple systemic embolisms to the spleen, kidney and extremities caused by complications of infective endocarditis (IE) in a single patient are rare and have fatal outcomes. Management of complications depends on the emergency and medical condition of patient. CASE PRESENTATION: Presented is a case of a 37 year old male with IE diagnosed initially with splenic abscess with multiple consultations and prolonged antibiotic intake. Percutaneous drainage of the abscess revealed heavy growth of Streptococcus sanguinis and blood culture shows growth of Capnocytophaga specie. Laparoscopic Splenectomy was done. During hospital stay patient developed Acute Limb Ischemia (ALI) IIB of the right upper extremity and emergency embolectomy was done. Valve Repair surgery was performed eventually and patient was discharged improved thereafter. DISCUSSION: Reported in this paper is a unique case of IE causing complications of splenic abscesses, renal infarcts and ALI with splenic abscess culture of Streptococcus sanguinis and blood culture of Capnocytophagia specie. Embolic complications occur in 20-50% of cases of IE. They can precede the diagnosis of IE in 25-60% of patients.1 Endocarditis as a result of Capnocytophaga canimorsus infection is extremely rare.2 The incidence of embolization causing ALI is unknown. Approximately 5% of patients with splenic infarction will develop splenic abscess. Current agreement states that IE and splenic abscesses should be treated during the same hospitalization, whether it comes first or after valve operation is still controversial. In our patient, the multiple complications of IE were addressed in same hospitalization stay. CONCLUSION: Management of complications of systemic embolism of IE entails a multidisciplinary and individualized approach. Antibiotic therapy, splenectomy, embolectomy and valve surgery on the same hospitalization can have satisfactory outcomes.