title: Intravenous thrombolysis is unsafe in stroke due to infective endocarditis.
abstract: Embolic stroke is the most common neurological complication of infective endocarditis and a major source of morbidity and mortality. Septic embolism is considered a contraindication to intravenous thrombolysis in patients with ischaemic stroke because of concerns over an increased risk of intracranial haemorrhage. We describe a patient with occult endocarditis who was treated with thrombolysis for acute stroke and review other cases reported in the literature.
authors: Department of Neurology, Auckland City Hospital, Auckland, New Zealand.
authors: W J
authors: WJ
authors: Brownlee
authors: N E
authors: NE
authors: Anderson
authors: P A
authors: PA
authors: Barber
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000075202:Contraindications; D004452:Echocardiography; D004696:Endocarditis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D010406:Penicillins / Q000008:administration & dosage; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D013298:Streptococcus sanguis / Q000302:isolation & purification*; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015912:Thrombolytic Therapy / Q000009:adverse effects; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D005839:Gentamicins; D010406:Penicillins; D010959:Tissue Plasminogen Activator
keywords: infective endocarditis; stroke; thrombolysis