Challenges of remote consultations: a delayed diagnosis of aortic valve endocarditis complicated by recurrent intracranial events.
BMJ Case Rep
; 15(2)2022 Feb 28.
Article
in English
| MEDLINE | ID: covidwho-1714388
ABSTRACT
Embolic events causing stroke and intracranial haemorrhage are among the most catastrophic complications of infective endocarditis (IE).A female patient presented with acute unilateral weakness following a 3-month history of fever, for which she had multiple remote consultations with her general practitioner. A brain MRI confirmed a left sided infarct with haemorrhagic transformation. Blood cultures grew Streptococcus mitis and her cardiac imaging showed an aortic valve vegetation with severe aortic regurgitation. Following 2 weeks of antibiotics she developed a new cerebral haemorrhage associated with a mycotic aneurysm which was treated with two coils. After discussions within the multidisciplinary meeting, she underwent aortic valve replacement 3 weeks later. She made a remarkable recovery and was discharged.Our case highlights the importance of face-to-face clinical review in the post-COVID era. It stresses that the management of patients with infective endocarditis and neurological complications is challenging and requires a multidisciplinary approach.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Remote Consultation
/
Endocarditis
/
Endocarditis, Bacterial
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
/
Qualitative research
Topics:
Long Covid
Limits:
Female
/
Humans
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Bcr-2021-248287
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