title: The role of side stream dark field microvasculature imaging in a rare case of vancomycin-resistant enterococcal endocarditis complicated by heparin-induced thrombocytopenia.
abstract: Sidestream dark field (SDF) imaging allows direct visualization of microvascular architecture and function. We examine the role of an SDF imaging device in visualizing the sub-lingual microvasculature as a surrogate for splanchnic microperfusion. We demonstrate good correlation between current monitoring techniques and the SDF imaging device in a rare case of vancomycin-resistant enterococcal (VRE) sepsis along with heparin-induced thrombocytopenia (HIT). To the best of our knowledge, VRE endocarditis with concurrent HIT has not been described in literature. The role of SDF imaging may predict the earlier need for escalation of care, improving morbidity and mortality.
authors.affiliation: Cardiothoracic Unit, Heart and Lung Centre, Wolverhampton, WV10 0QP, United Kingdom.
authors.forename: Janak
authors.initials: J
authors.lastname: Bechar
authors.forename: Luigi
authors.initials: L
authors.lastname: Polesello
authors.forename: Maria
authors.initials: M
authors.lastname: Lombrano
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Martinelli
authors.forename: Heyman
authors.initials: H
authors.lastname: Luckraz
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects*; D002196:Capillaries / Q000473:pathology*; D003326:Coronary Circulation; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000473:pathology*; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications*; D020713:Vancomycin Resistance
chemical_list: D000925:Anticoagulants; D006493:Heparin