Infective Endocarditis with Systemic Septic Emboli

ABSTRACT

Infective endocarditis is still one of the important fatal diseases, especially with systemic embolic manifestations. Infective endocarditis is often misdiagnosed because of variability of systemic embolic manifestations. We have experienced 3 cases of infective endocarditis with systemic embolic manifestations who were initially misdiagnosed as other infectious diseases. Case 1 is a 66 year-old man, who was admitted to our hospital with dyspnea , fever and petechia. His chest X-ray showed rapid decrease of cardiomegaly and pulmonary congestion in two days. At 1 week after discharge he was readmitted for recurrent fever. On the follow-up echocardiography, mitral regurgitation was newly detected. Case 2 is a 75 year-old man, who was admitted to neurology department with sudden left hemiplegia and headache, in whom it was initially difficult to differentiate from ischemic brain infarction. Case 3 is a 29 year-old man, who was admitted to neurosurgery department with fever and back pain, in whom it was initially difficult to diffrentiate from tuberculous spondylitis in early radiologic study. All 3 cases were treated effectively with appropriate antibiotic therapy and discharged with improvement of symptoms. We report 3 cases of systemic embolic manifestations complicated by infective endocarditis with a brief review of literatures.