Primary mural infective endocarditis with associated central line infection

• Published in: BMJ case reports 2018-12, Vol.11 (1), p.e227504
• Main Authors: Agrawal, Yashwant, Dada, Rachel, Dada, Jafar, Degregorio, Michelle
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Cardiac Surgical Procedures; Case reports; Catheter-Related Infections - complications; Catheter-Related Infections - diagnosis; Catheters; Central Venous Catheters; Echocardiography; Endocarditis; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - diagnostic imaging; Endocarditis, Bacterial - therapy; Endothelium; Female; Heart Atria - surgery; Humans; Images In; Middle Aged; Staphylococcal Infections - complications; Staphylococcal Infections - diagnosis; Staphylococcal Infections - diagnostic imaging; Staphylococcal Infections - therapy; Staphylococcus aureus; Staphylococcus infections; Surgery; Ultrasonic imaging; Urinary tract infections; Vegetation
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2018-227504

Three weeks prior, a right-sided central venous access port was inserted for antibiotic administration for a recurrent urinary tract infection (UTI). Since the procedure, she had aching right-sided shoulder pain, lethargy, fever, chills, vomiting, weight loss, cough and sore throat. Mural infective endocarditis (IE) occurs when growth of bacteria is present on cardiac walls while valvular endothelium is spared.1 Major risk factors for mural IE include diabetes mellitus, cardiovascular disease and malignancy.2 Only 19 case reports (20 cases in total) of primary mural IE have been published.2 The most common pathogen is S. aureus (60%). [...]high-resolution TEE imaging is the preferred diagnostic method.1 2 Expedient diagnosis is imperative so treatment may be initiated, as life-threatening complications, such as embolisation, may develop rapidly.2 Our case represents a rare instance of isolated mural IE associated with a central venous access port infection.