Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 6, 2023; 11(16): 3822-3829
Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3822
Valve repair after infective endocarditis secondary to perforation caused by Streptococcus gordonii: A case report
Yi-Fan Qu, Jun Yang, Jun-Yu Wang, Bing Wei, Xing-Hua Ye, Yi-Xuan Li, Si-Lu Han
Yi-Fan Qu, Jun Yang, Jun-Yu Wang, Bing Wei, Xing-Hua Ye, Yi-Xuan Li, Si-Lu Han, Department of Emergency, Beijing Chaoyang Hospital Jingxi Branch, Beijing 100000, China
Author contributions: Qu YF and Yang J contributed equally to this work; Qu YF, Yang J, Wang JY, and Wei B designed the research study; Han SL, Li YX, and Ye XH provided the medical records and obtained patient consent; All authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun Yang, MD, Doctor, Researcher, Teacher, Department of Emergency, Beijing Chaoyang Hospital Jingxi Branch, No.5 Jinyuan Road, Shijingshan District, Beijing 100000, China. yangjun26@sina.com
Received: November 26, 2022
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
Processing time: 187 Days and 23.5 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

We review the treatment process and highlight inspirations and reflections from this case; suggest possible future changes in treatment modalities.

Keywords: Bacteremia; Comprehensive medical and surgical treatment; Streptococcus gordonii; Infective endocarditis; Case report

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.