Infectious endocarditis presenting as intracranial hemorrhage in a patient admitted for lumbar radiculopathy.
Infectious endocarditis is frequently found in the neurologic intensive care unit and may rarely be the cause of intracranial hemorrhage. In such instances, further diagnostic imaging to search for an underlying structural lesion is prudent. Well-known causes of these hemorrhages include cardioembolism with hemorrhagic transformation, septic emboli, and mycotic aneurysms. We present a case of a patient who was admitted for routine evaluation and pain management of lumbar radiculopathy, who developed a large intraparenchymal hemorrhage and was found to have bacterial endocarditis. This was diagnosed retrospectively from positive hematoma cultures and a vegetation on transesophageal echocardiogram. Further evaluation revealed a mycotic aneurysm.
Miller School of Medicine University of Miami, Department of Neurology, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136, USA.
David Ethan
DE
Kahn
Miller School of Medicine University of Miami, Department of Neurology, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136, USA.
Kristine
K
O'Phelan
Jackson Memorial Hospital, Department of Neurosurgery, 1095 NW 14th Ter No. 2, Miami, FL 33136-1060, USA.
Ross
R
Bullock