Abstract

DA PONTE ROJAS, María Noemí  and  GUGGIARI, Johanna Natali. Impairment of the sensorium in a patient with infective endocarditis in an inpatient ward. An. Fac. Cienc. Méd. (Asunción) [online]. 2021, vol.54, n.3, pp.151-154. ISSN 1816-8949.  https://doi.org/10.18004/anales/2021.054.03.151.

The case presented below goes beyond the early diagnosis of infective endocarditis and the association of the patient's prognosis with timely treatment; It is also important to keep in mind about possible complications despite adequate clinical management.

A male patient consulted for a fever of eight days of evolution, the positive finding on physical examination was the auscultation of a diastolic murmur in the aortic focus. Positive blood cultures returned for streptococcus gallolyticus, antibiotic treatment had been started according to the antibiogram, and in the second week of treatment there was deterioration of the sensorium. A simple skull tomography had been performed in the first instance and then brain magnetic resonance imaging showing lesions compatible with possible complications of infective endocarditis. The same antibiotic scheme was continued for six weeks with improvement of the sensorium.

The isolated germ in the clinical case is related in a not infrequent percentage in patients with gastrointestinal pathologies, the positive data that was obtained within their physiological habits was chronic constipation as important data since it is frequently related to intestinal polyps or neoplasms that are ruled out with complementary studies. In addition, the pathogens frequently involved in neurological complications were S. aureus and Streptococcus gallolyticus, the latter coinciding with the isolated germ in this clinical case, in addition to presenting two of the many complications such as ischemic stroke and septic embolism in the same patient.

Keywords : Endocarditis; Complications; Embolism..

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