RESUMO
A 66-year-old female with Streptococcus viridans aortic and tricuspid infective endocarditis develops, during the course of antibiotic therapy, rupture of a right coronary sinus of Valsalva aneurysm to the right ventricle. An urgent cardiac surgery is preformed with implantation of a mechanical aortic prosthesis and a right coronary sinus plasty. Six months later a huge aortic pseudoaneurysm is diagnosed and she is submitted to a second uneventful surgery. A review is done for the significant features with discussion of diagnosis and therapy.
Assuntos
Falso Aneurisma/etiologia , Ruptura Aórtica/etiologia , Endocardite Bacteriana/etiologia , Doenças das Valvas Cardíacas/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Infecções Estreptocócicas/etiologia , Estreptococos Viridans , Idoso , Falso Aneurisma/cirurgia , Aneurisma Roto/cirurgia , Ruptura Aórtica/cirurgia , Valva Aórtica/microbiologia , Valva Aórtica/cirurgia , Implante de Prótese Vascular , Aneurisma Coronário/cirurgia , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/cirurgia , Feminino , Doenças das Valvas Cardíacas/microbiologia , Doenças das Valvas Cardíacas/cirurgia , Ventrículos do Coração/patologia , Ventrículos do Coração/cirurgia , Humanos , Reoperação , Seio Aórtico/patologia , Seio Aórtico/cirurgia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/cirurgia , Valva Tricúspide/microbiologia , Valva Tricúspide/cirurgiaRESUMO
Fever of unknown origin in elderly patients is a difficult diagnostic problem. Infective endocarditis is often not diagnosed in this group of patients, in whom other etiologies like cancer are considered first. The authors report a case in which an elderly woman with subacute mitral and tricuspid infective endocarditis was correctly diagnosed only after a peripheral embolism. Besides having multiple pulmonary and peripheral embolisms, she developed a left femoral mycotic aneurysm.
