Disastrous course of recurrent infective endocarditis after tooth extraction in a young patient with bicuspid aortic valve.
In a patient with moderate malformations of the left-ventricular valves disregard of antibiotic prophylaxis after tooth extraction resulted in massive mitral- and aortic regurgitation. After surgical reconstruction a relapse produced an aorto left-ventricular fistula with septic embolizations and cardiac decompensation. Valve replacement with a homograft reconstituted the hemodynamic situation. During both episodes the Duke criteria for infective endocarditis supported the diagnosis.
Abteilung für Kinderkardiologie, Universitätskinderklinik Graz, Austria. p.zartner@asklepios.com
P
P
Zartner
A
A
Gamillscheg
B
B
Rigler
A
A
Beitzke
D000038:Abscess / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D001705:Bioprosthesis; D004359:Drug Therapy, Combination; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D014081:Tooth Extraction; D016312:Treatment Refusal; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery
D000900:Anti-Bacterial Agents