[Gonococcal endocarditis: an infection as rare as it dangerous. Apropos of a case: the importance of suspicion in diagnosis and of immediate treatment].
Gonococcal endocarditis, although extremely rare, is increasing in frequency, particularly among young exposed patients. It has a distinct predilection for aortic and mitral valve involvement and tends to cause rapid valvular destruction and acute heart failure. Blood cultures are often negative during the first (3 to 31) days. Echocardiography with Doppler is helpful in detecting valvular vegetations, regurgitation and signs of hemodynamic deterioration. Early antibiotic treatment may stabilize the hemodynamic situation only in mitral but not in aortic valve involvement, which necessitates prompt valvular replacement in the event of perforation and/or annulus abscess. Gonococcal endocarditis should be the first item to be excluded in cases of fever with systemic symptoms in young people with a history of sex-transmitted disease. We present a typical case.
de'Clari
F
F
Unité de soins intensifs et clinique médicale, Ospedale civico, Lugano.
Nikolic
J
J
Genoni
M
M
Riva
A
A
Moccetti
T
T
D000328:Adult; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D015150:Echocardiography, Doppler; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006069:Gonorrhea / Q000150:complications*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology; D009344:Neisseria gonorrhoeae
L'endocardite à gonocoques: une infection aussi rare que dangereuse. A propos d'un cas: importance du diagnostic de suspicion et du traitement immédiat.