Affiliation:
1. GCS Medical College, Hospital and Research Centre (M.B.B.S.)
Abstract
Infective endocarditis is an infectious and inammatory process involving endothelial lining of heart structures and valves. Cerebrovascular
complications (CVCs) frequently occur in patients who are in the active stage of infective endocarditis (IE), and result from cerebral septic
embolization of an endocardial vegetation. Acute stroke due to septic emboli is a particularly dreaded complication , with a frequency of 25-35%.
Here we present a case of 32 year old male patient, who comes to the ER with high grade fever and palpitations since 9 days. On examination we
found hyperdynamic impulse with decrescendo type systolic murmur at mitral area and we decided to do a blood workup and also requested a 2D
ECHO. Blood culture and 2D ECHO showed different species of streptococci and mitral regurgitation respectively. Based on the investigations we
started the patient on antibiotics, However, on the day 7 of treatment, patient developed slurring of speech and hemiparesis followed by motor
aphasia. We sent the patient for brain MRI that showed acute infarct in left central semioval, left corona radiata and left perisylvian region. Acute
ischemic stroke is the complication of the infective endocarditis and we started tpAalong with intravenous antibiotics after which he experienced
signicant clinical improvement in few days.