title: Bicuspid aortic valve endocarditis complicated by perivalvular abscess.
abstract: A 37-year-old man presenting with fever and chest pain was admitted to our hospital. Electrocardiogram showed sinus tachycardia and complete left bundle branch block. Transthoracic echocardiogram showed infective endocarditis in the bicuspid aortic valve, complicated by multiple hyperechoic vegetations and severe aortic regurgitation. Blood cultures were negative and intravenous empiric antibiotic therapy was begun. However, fever lasted for 7 days and follow-up echocardiography revealed a newly emerged perivalvular abscess. The patient eventually underwent an urgent aortic root replacement that confirmed the echocardiographic findings. Our case report emphasizes that all patients with suspected aortic valve endocarditis should undergo early and follow-up echocardiographic studies.
authors.affiliation: Department of Cardiovascular Medicine, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Soeki
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Niki
authors.forename: Kenya
authors.initials: K
authors.lastname: Kusunose
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taketani
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwase
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Yamada
authors.forename: Tetsuzo
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: Masashi
authors.initials: M
authors.lastname: Akaike
authors.forename: Masataka
authors.initials: M
authors.lastname: Sata
mesh_terms: D000038:Abscess / Q000150:complications*; D000328:Adult; D001021:Aortic Valve / Q000002:abnormalities; D000082882:Bicuspid Aortic Valve Disease; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000209:etiology*; D006349:Heart Valve Diseases / Q000150:complications*; D006801:Humans; D008297:Male