Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report

Introduction: Infective endocarditis (IE) is known to precipitate several severe complications, often culminating in dire outcomes. In this report, we present the case of a 33-year-old female with IE, which was further complicated by the occurrence of brain infarction, meningitis, and infectious ane...

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Main Authors: Yeting Luo, Zhijuan Lu, Yunhui Zhu, Zhaohui Lai
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250924001628
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author Yeting Luo
Zhijuan Lu
Yunhui Zhu
Zhaohui Lai
author_facet Yeting Luo
Zhijuan Lu
Yunhui Zhu
Zhaohui Lai
author_sort Yeting Luo
collection DOAJ
description Introduction: Infective endocarditis (IE) is known to precipitate several severe complications, often culminating in dire outcomes. In this report, we present the case of a 33-year-old female with IE, which was further complicated by the occurrence of brain infarction, meningitis, and infectious aneurysm. Case report: A 33-year-old female patient, presenting with left limb weakness persisting for a duration of 15 h, was admitted to our medical facility. A head MRI scan disclosed the presence of an acute cerebral infarction located in the left hemisphere, and subsequent CT angiography confirmed an occlusion of the M1 segment of the left middle cerebral artery. Consequently, the patient underwent mechanical thrombectomy as an intervention. Several days later, echocardiography revealed the presence of a 6.5 × 3.2 mm vegetation on the anterior mitral valve cusp, while blood cultures returned positive for Streptococcus mitis. A diagnosis of IE was established, and antibiotic therapy tailored to the microbiological sensitivities was promptly initiated. However, on the ninth day of her hospitalization, the patient's clinical condition deteriorated significantly due to the emergence of critical complications, including meningitis and a infectious aneurysm. Despite the implementation of aggressive antibiotic therapy, her condition continued to worsen, ultimately resulting in her demise on the sixteenth day of hospitalization, precipitated by the rupture of the infectious aneurysm. Conclusions: The occurrence of infective endocarditis alongside brain infarction, meningitis, and infectious aneurysm in a single patient represents a rare, intricate, and gravely serious clinical scenario. In such instances, the responsibility for management should be vested in a multidisciplinary team of healthcare professionals.
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spelling doaj-art-54cb4b1a76ed45e79928ea85c9e7d65b2025-08-20T02:37:28ZengElsevierIDCases2214-25092024-01-0138e0208610.1016/j.idcr.2024.e02086Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case reportYeting Luo0Zhijuan Lu1Yunhui Zhu2Zhaohui Lai3Department of Neurology, Ganzhou People ’s Hospital, Nanchang University, Jiangxi 341000, ChinaDepartment of Neurology, Ganzhou People ’s Hospital, Nanchang University, Jiangxi 341000, ChinaDepartment of Neurology, Ganzhou People ’s Hospital, Nanchang University, Jiangxi 341000, ChinaCorresponding author.; Department of Neurology, Ganzhou People ’s Hospital, Nanchang University, Jiangxi 341000, ChinaIntroduction: Infective endocarditis (IE) is known to precipitate several severe complications, often culminating in dire outcomes. In this report, we present the case of a 33-year-old female with IE, which was further complicated by the occurrence of brain infarction, meningitis, and infectious aneurysm. Case report: A 33-year-old female patient, presenting with left limb weakness persisting for a duration of 15 h, was admitted to our medical facility. A head MRI scan disclosed the presence of an acute cerebral infarction located in the left hemisphere, and subsequent CT angiography confirmed an occlusion of the M1 segment of the left middle cerebral artery. Consequently, the patient underwent mechanical thrombectomy as an intervention. Several days later, echocardiography revealed the presence of a 6.5 × 3.2 mm vegetation on the anterior mitral valve cusp, while blood cultures returned positive for Streptococcus mitis. A diagnosis of IE was established, and antibiotic therapy tailored to the microbiological sensitivities was promptly initiated. However, on the ninth day of her hospitalization, the patient's clinical condition deteriorated significantly due to the emergence of critical complications, including meningitis and a infectious aneurysm. Despite the implementation of aggressive antibiotic therapy, her condition continued to worsen, ultimately resulting in her demise on the sixteenth day of hospitalization, precipitated by the rupture of the infectious aneurysm. Conclusions: The occurrence of infective endocarditis alongside brain infarction, meningitis, and infectious aneurysm in a single patient represents a rare, intricate, and gravely serious clinical scenario. In such instances, the responsibility for management should be vested in a multidisciplinary team of healthcare professionals.http://www.sciencedirect.com/science/article/pii/S2214250924001628Brain infarctionInfective endocarditisMechanical thrombectomyMeningitisInfectious aneurysm
spellingShingle Yeting Luo
Zhijuan Lu
Yunhui Zhu
Zhaohui Lai
Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
IDCases
Brain infarction
Infective endocarditis
Mechanical thrombectomy
Meningitis
Infectious aneurysm
title Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
title_full Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
title_fullStr Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
title_full_unstemmed Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
title_short Severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis: A case report
title_sort severe meningitis and infectious aneurysm rupture of the middle cerebral artery following mechanical thrombectomy in infective endocarditis a case report
topic Brain infarction
Infective endocarditis
Mechanical thrombectomy
Meningitis
Infectious aneurysm
url http://www.sciencedirect.com/science/article/pii/S2214250924001628
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