Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3822
Peer-review started: November 26, 2022
First decision: February 7, 2023
Revised: February 24, 2023
Accepted: April 27, 2023
Article in press: April 27, 2023
Published online: June 6, 2023
We report a case of infective endocarditis (IE) in a patient with congenital heart valve lesions accompanied by IE, which was diagnosed based on blood culture analysis that revealed the presence of a gram-negative bacterium, Streptococcus gordonii.
The patient had a history of precordial valve disease diagnosed by cardiac ultrasound, as well as a 4-mo history of fever. He was subjected to comprehensive anti-infection and anti-heart failure treatment in the internal medicine department. Further examination revealed sudden dislodgement from and perforation through the aortic valve by the superfluous organisms, as well as occurrence of bacterial emboli dislodgement, which caused bacteremia and infectious shock. He recovered and was discharged from the hospital after surgical and postoperative anti-infection treatments.
We review the treatment process and highlight inspirations and reflections from this case; suggest possible future changes in treatment modalities.
Core Tip: Infective endocarditis is caused by pathogenic bacteria that infect the heart via the bloodstream. It is most common in heart valves but also in atrioventricular walls, tendons and other structures. Congenital heart disease is common in heart structures near the abnormal intracardiac shunt low-pressure cavities, and serious cases can be accompanied by abscesses, fistulas and other cardiac complications. The fallen flap or leaflet can cause embolism of various organs throughout the body, has a high mortality rate, and there are no specific clinical manifestations. It is very easy to misdiagnose, and missed diagnoses are common. The search for sensitive diagnostic methods and timely treatment are particularly important.