title: Infective endocarditis in bicuspid aortic valve: atrioventricular block as sign of perivalvular abscess.
abstract: A 46-year-old man presenting with fever, peripheral edema, and chest pain was admitted to the emergency department. Electrocardiogram showed sinus tachycardia and first-degree atrioventricular block. Transesophageal echocardiogram showed infective endocarditis in bicuspid aortic valve, complicated with severe aortic regurgitation, ring abscess, and sinus-of-Valsalva aneurysm extending to mitroaortic fibrous continuity. The patient, who was unaware of his bicuspid aortic valve condition, reported having undergone an orthodontic procedure complicated with dental abscess 1 month prior, which was treated with combined clavulanate-amoxicillin antibiotic therapy. Blood cultures were positive for Bacteroides fragilis resistant to metronidazole. Intravenous antibiotic therapy was undertaken, with rapid resolution of fever. He eventually underwent successful aortic homograft implantation and mitral valve repair with residual first-degree atrioventricular block.
authors.affiliation: Institute of Pathology, University of Padua Medical School, Padua, Italy; Department of Cardio-Thoracic and Vascular Sciences, University of Padua Medical School, Padua, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bacchion
authors.forename: Sonja
authors.initials: S
authors.lastname: Cukon
authors.forename: Giulio
authors.initials: G
authors.lastname: Rizzoli
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Luciano
authors.initials: L
authors.lastname: Daliento
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
mesh_terms: D000038:Abscess / Q000209:etiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000601:surgery; D006327:Heart Block / Q000209:etiology*; D006349:Heart Valve Diseases / Q000151:congenital* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology / Q000473:pathology* / Q000637:transplantation; D009971:Orthodontics, Corrective / Q000009:adverse effects*; D009057:Stomatognathic Diseases / Q000188:drug therapy; D014184:Transplantation, Homologous
chemical_list: D000900:Anti-Bacterial Agents