A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives
Issued Date
2023-01-01
Resource Type
eISSN
24146366
Scopus ID
2-s2.0-85146788773
Journal Title
Tropical Medicine and Infectious Disease
Volume
8
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Tropical Medicine and Infectious Disease Vol.8 No.1 (2023)
Suggested Citation
Shafeeq A., Imad H.A., Azhad A., Shareef M., Najmy M.S., Siraj M.M., Sunil M., Rafeeu R., Moosa A.S., Shaheed A., Ngamprasertchai T., Matsee W., Aung P.L., Nguitragool W., Shioda T. A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives. Tropical Medicine and Infectious Disease Vol.8 No.1 (2023). doi:10.3390/tropicalmed8010053 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/81971
Title
A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives
Other Contributor(s)
Abstract
Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.