Erratum: [Erratum] Escherichia Coli Endocarditis and Cardiac Abscess: A Rare Presentation in a Patient with a Prosthetic Aortic Valve.

[This corrects the article DOI: 10.12890/2023_004203.].

Escherichia Coli Endocarditis and Cardiac Abscess: A Rare Presentation in a Patient with a Prosthetic Aortic Valve.

Introduction: There are very few documented cases of Escherichia coli endocarditis with cardiac abscesses in the literature. Here we describe a case presentation with diagnostic challenges and a multidisciplinary approach to management. Case description: This is a rare presentation of E. coli endocarditis in a patient with a prosthetic aortic valve. Initial tests were inconclusive and further investigation with transoesophageal echocardiography was required to make the diagnosis. Despite initial improvement, the patient deteriorated and ultimately died of complications related to the presentation. Discussion/conclusion: E. coli is a rare causative organism for endocarditis, which can itself be difficult to diagnose. A multidisciplinary approach to investigation and treatment is required when infective endocarditis is suspected. Transoesophageal echocardiography may be required to diagnose endocarditis when there is a strong clinical suspicion and risk factors present. LEARNING POINTS: Infective endocarditis should be thoroughly investigated for in cases where there is a high clinical suspicion, but atypical organisms grown in blood cultures.A transoesophageal echocardiogram (TOE) may be a better imaging modality when endocarditis is strongly suspected, in comparison to a transthoracic echocardiogram (TTE).Escherichia coli endocarditis carries a high mortality rate, and early intervention is key in managing patients presenting with suspected endocarditis.

Guillain-barré syndrome without limb weakness: A rare variant with acute bulbar palsy.

A 76-year-old male was brought to the emergency room with an acute onset of breathlessness and difficulty swallowing. Examination revealed bilateral ptosis, bilateral vocal cord abductor palsy with diaphragmatic paralysis. He did not have any limb weakness. A diagnosis of acute bulbar palsy was made. Cerebrospinal fluid showed albumino-cytological dissociation. Magnetic resonance imaging of the brain (MRI) was normal, and a nerve conduction study (NCS) showed Acute Motor and Sensory Axonal Neuropathy (AMSAN). Guillain-Barré syndrome with acute bulbar palsy was considered. Here, we report a case of suspected Acute Bulbar Palsy plus (ABPp) syndrome. ABPp may be considered as a variant of GBS between the Miller-fisher and Pharyngeal-cervical-brachial variant and does not have any definite limb weakness. This patient also had ABPp with diaphragmatic palsy. However, whether this syndrome is an isolated variant of GBS or a continuum between the Miller-fisher syndrome (MFS) and Pharyngo-cervical brachial (PCB) variants remains to be elucidated. This case is relevant to primary care physicians as the disability with GBS remains high and may render a large burden to carers. The initial symptom of acute dysphagia must lead on the primary care physician to keep this disease in mind to prevent an unwarranted delay in diagnosis.