Cerebral ischemia caused by Streptococcus bovis aortic endocarditis: case report.
Cerebral ischemic processes associated with infective endocarditis caused by Streptococcus bovis are rare; only 2 cases having been reported. Here we report a case of a 50-year-old man with S. bovis endocarditis who presented signs of frontal, parietal and occipital lobe cerebral ischemia. This is the first case reported in which the presence of hemianopsia preceded the endocarditis diagnosis. Initially, the clinical manifestations suggested a systemic vasculitis. Later, vegetating lesions were identified in the aortic valve and S. bovis grew in blood cultures. Antibiotic use and aortic valve replacement eliminated the infection and ceased thromboembolic events. A video colonoscopy examination revealed no mucosal lesions as a portal of entry in this case, although such lesions have been encountered in up to 70% of reported cases of S. bovis endocarditis.
Santos-Neto
Leopoldo
L
Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil. leoneto@uninet.com.br
Gangoni
Camila
C
Pereira
Viviane
V
Corrêa-Lima
Rodrigo
R
D001021:Aortic Valve / Q000382:microbiology* / Q000601:surgery; D001705:Bioprosthesis; D002545:Brain Ischemia / Q000188:drug therapy / Q000209:etiology*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D006350:Heart Valve Prosthesis; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000150:complications* / Q000382:microbiology / Q000628:therapy; D016985:Streptococcus bovis