Clinical characteristics of patients with infective endocarditis complicated with cerebral hemorrhage / 中国医师杂志

ABSTRACT

Objective:To summarize and analyze the clinical characteristics of patients with infective endocarditis (IE) complicated with cerebral hemorrhage.Methods:The clinical data of 15 IE patients with intracerebral hemorrhage diagnosed in the Affiliated Hospital of Xuzhou Medical University from January 2010 to December 2021 were analyzed retrospectively, and their clinical characteristics were analyzed, including the mode of onset, cranial imaging characteristics, associated diseases, echocardiography, hematology, etiology, chest computed tomography (CT), cerebrospinal fluid characteristics, treatment methods and prognosis of patients.Results:Cerebral hemorrhage in IE patients were acute or subacute onset. Head CT scanning showed that cerebral hemorrhage usually occurred in the brain lobe, can be combined with rheumatic heart disease, congenital heart defect or immune system diseases, etc. Ultrasonic cardiogram can be used to determine the location of vegetations in the heart cavity, the damage of the valve and the hemodynamic changes. The hematologic examination showed elevated hemogram and increased erythrocyte sedimentation rate. Staphylococcus aureus or streptococcus viridans were often detected on the etiological examination. Lung infection was often seen on a chest CT, and inflammatory changes were seen in the cerebrospinal fluid. IE was treated with sufficient course of antibiotics and valve replacement with valve damage. The case fatality rate was 3/15.Conclusions:Young patients presented with lobar hemorrhage, headache, fever and rheumatic heart disease should be thought of the possibility of IE combined with cerebral hemorrhage. IE with intracerebral hemorrhage has a poor prognosis and a high mortality.