Recurrent infective endocarditis in a patient with severe Crohn's disease
, 1, 1
Abstract
27-year old patient after mitral valve replacement because of infective endocarditis (IE) in 2013, treated with biological medicaments for Crohn’s disease was admitted to the hospital because of fever and neurological symptoms. ECG at the admission revealed signs of myocardial ischemia. In computed tomography scanning signs of septic embolism were found. In managed transoesophageal echocardiography (TEE) vegetation near mechanical prosthesis annulus was identified. Urgent coronary artery angiography revealed 100% stenosis in the circumflex artery. Because of the unsatisfactory result of the immediately managed percutaneous coronary intervention, pharmacological treatment of coronary artery disease was managed on the regular basis. Due to the definite diagnosis of IE empiric antibiotic therapy was initiated. After receiving microbiological blood test results the targeted antibiotic therapy was implemented. Anticoagulant treatment with acenocoumarol was being managed during the whole hospitalisation. The gradual improvement in general condition and regression of vegetation in TEE were observed.
Keywords: infective endocarditisCrohn’s disease
References
- Thuny F, Di Salvo G, Disalvo G, et al. Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study. Circulation. 2005; 112(1): 69–75.
- Habib G, Lancellotti P, Antunes M, et al. 2015 ESC Guidelines for the management of infective endocarditis. Eur Heart J. 2015; 36(44): 3075–3128.
- Alzubi J, Zmaili M, Alkhayyat M, et al. Infective endocarditis in inflammatory bowel disease: significance and outcomes. J Am Coll Cardiol. 2021; 77(18_Suppl_1).
- Shah-Khan SM, Shah-Khan SM, Alqahtani F, et al. Increasing rates of infective endocarditis in patients with inflammatory bowel disease. Cureus. 2020; 12(2): e6919.
- Bonovas S, Fiorino G, Allocca M, et al. Biologic therapies and risk of infection and malignancy in patients with inflammatory bowel disease: a systematic review and network meta-analysis. Clin Gastroenterol Hepatol. 2016; 14(10): 1385–1397.e10.
