Aortic root abscess from Enterococcus faecalis infective endocarditis: Case report and brief review of the literature

• Published in: Radiology case reports 2022-11, Vol.17 (11), p.4193-4198
• Main Authors: Hathaway, Quincy A., Balar, Aneri B., Mallicoat, Taylor A., Voss, Jeffery A., Amin, Md Shahrier, Lakhani, Dhairya A., Kim, Cathy
• Format: Article
• Language: English
• Subjects: Aortic root abscess; Bentall procedure; Case Report; Infective endocarditis; Modified Duke criteria; Paravalvular abscess
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2022.08.011

Infective endocarditis is a life-threatening disease that is associated with a significant risk of morbidity and mortality. One of the most serious complications of infective endocarditis is perivalvular and aortic root abscess formation. Due to the high propensity for rupture and continued spread within the aorta and surrounding organs, surgical management is recommended and can improve long-term survival. Imaging plays a critical role in diagnosis of infective endocarditis and its sequalae. Initial workup includes transthoracic and/or transesophageal echocardiography, as part of the modified Duke criteria for diagnosing infective endocarditis. If paravalvular abscesses are suspected, CTA chest can characterize invasion and spread of the abscess. Here, we present a 55-year-old male with recurrent infective endocarditis with an aortic root abscess. The abscess was first identified through transesophageal echocardiography and subsequently confirmed using CTA chest. Surgically, the patient required pulmonic and aortic valve replacement along with aortic root reconstruction.