Complicated Infective Endocarditis Limited to a Chiari Network
Introduction. The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain. Case summary. A 61-yea...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2018/3837825 |
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| author | Olufolahan Carrena Oluchukwu Oluoha Amr Wahba Derek Eshun Maria Endsley Henry Okafor |
| author_facet | Olufolahan Carrena Oluchukwu Oluoha Amr Wahba Derek Eshun Maria Endsley Henry Okafor |
| author_sort | Olufolahan Carrena |
| collection | DOAJ |
| description | Introduction. The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain. Case summary. A 61-year-old man was admitted with a 2-month history of hemoptysis, pleuritic chest pain, and right upper extremity numbness and weakness. He was found to have multifocal bilateral pulmonary opacities and an abscess collection in the brain. Blood cultures grew Streptococcus intermedius and transthoracic echocardiogram (TTE) was normal. Subsequent transesophageal echocardiogram (TEE) revealed an 8.3 × 4.6 mm vegetation arising from the Chiari network, close to the right atrial appendage, without involvement of the tricuspid valve or any of the other valves. There were no atrial or ventricular septal defects. He was treated with appropriate antibiotics with improvement of symptoms. Repeat imaging showed improvement of the lung opacities, but not the brain abscess, warranting transfer to another hospital for neurosurgical intervention. Conclusion. The diagnosis and management of isolated Chiari network endocarditis require a high index of clinical suspicion. A multidisciplinary approach incorporating both medical and surgical approaches where necessary is essential for optimal outcome. |
| format | Article |
| id | doaj-art-87f5b8217bf94b38acc9209931ea0e13 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-87f5b8217bf94b38acc9209931ea0e132025-08-20T03:37:33ZengWileyCase Reports in Cardiology2090-64042090-64122018-01-01201810.1155/2018/38378253837825Complicated Infective Endocarditis Limited to a Chiari NetworkOlufolahan Carrena0Oluchukwu Oluoha1Amr Wahba2Derek Eshun3Maria Endsley4Henry Okafor5Meharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAMeharry Medical College, Nashville, TN, USAIntroduction. The Chiari network is an uncommon vestigial structure of the heart that is often clinically insignificant. We present an unusual case of infective endocarditis affecting only the Chiari network in a patient who presented with septic emboli to the lungs and brain. Case summary. A 61-year-old man was admitted with a 2-month history of hemoptysis, pleuritic chest pain, and right upper extremity numbness and weakness. He was found to have multifocal bilateral pulmonary opacities and an abscess collection in the brain. Blood cultures grew Streptococcus intermedius and transthoracic echocardiogram (TTE) was normal. Subsequent transesophageal echocardiogram (TEE) revealed an 8.3 × 4.6 mm vegetation arising from the Chiari network, close to the right atrial appendage, without involvement of the tricuspid valve or any of the other valves. There were no atrial or ventricular septal defects. He was treated with appropriate antibiotics with improvement of symptoms. Repeat imaging showed improvement of the lung opacities, but not the brain abscess, warranting transfer to another hospital for neurosurgical intervention. Conclusion. The diagnosis and management of isolated Chiari network endocarditis require a high index of clinical suspicion. A multidisciplinary approach incorporating both medical and surgical approaches where necessary is essential for optimal outcome.http://dx.doi.org/10.1155/2018/3837825 |
| spellingShingle | Olufolahan Carrena Oluchukwu Oluoha Amr Wahba Derek Eshun Maria Endsley Henry Okafor Complicated Infective Endocarditis Limited to a Chiari Network Case Reports in Cardiology |
| title | Complicated Infective Endocarditis Limited to a Chiari Network |
| title_full | Complicated Infective Endocarditis Limited to a Chiari Network |
| title_fullStr | Complicated Infective Endocarditis Limited to a Chiari Network |
| title_full_unstemmed | Complicated Infective Endocarditis Limited to a Chiari Network |
| title_short | Complicated Infective Endocarditis Limited to a Chiari Network |
| title_sort | complicated infective endocarditis limited to a chiari network |
| url | http://dx.doi.org/10.1155/2018/3837825 |
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