Abstract:
Introduction. Infective endocarditis (IE) is a serious infectious disease, with polyorganic
complications, which causes a high risk of death (20-25%). In 20-40% of cases, IE is
complicated by neurological disorders as: stroke, mycotic aneurysms, meningitis, cranial
nerve paresis and cerebral hemorrhages.
Aim of the study. Presentation of the patient's clinical case with infective endocarditis
complicated by ischemic stroke. The importance of complex treatment in patients with IE
with neurological involvement.
Materials and methods. 59-year-old male, with IE caused by beta-hemolytic streptococcus
with mitral valve (VM) involvement, hospitalized in the Institute of Cardiology in severe
condition. From the anamnesis: onset with a stroke. Clinically and paraclinically examined
by: blood cultures, ECOCG, clinical and biochemical analyses, consulted by a neurologist.
Results. Fever 39oC, chills, motor aphasia, paresis on the right side. Objective(s).: pale skin,
petechiae, Janeway lesions. Rhythmic heart murmurs, HR 90 b/min, systolic murmur at the
apex and diastolic at the aorta, BP 90/50 mmHg. Paraclinically: BC beta-hemolytic
streptococcus. ECOCG: mobile vegetations on MV 10 mm and AoV 12 mm; regurgitation on
MV, VAo and VTs of grade III, EF 56%; Radiologically – bilateral septic pneumonia; Hb 89
g/l, erythrocytes 2.8x1012, leukocytes 11x109, ESR 66 mm/h; ASLO-1:400; FR 48 U/l.
Treatment with 2 antimicrobial regimens in maximum doses, antifungals, diuretics,
fractionated direct anticoagulants, nootropic medication.
Conclusion(s). Infective endocarditis can often occur with polyorganic embolic
complications, more frequently with stroke and pulmonary thromboembolism, which
negatively influence the evolution and prognosis of the disease, causing disability. The
treatment of these patients is complex and individualized.
