EC Cardiology

Infective endocarditis (IE) is a rare life-threatening condition often complicated by splenic emboli with splenic infraction being an uncommon presentation. We report a 34-year-old man, presenting with acute left flank pain and fever. Imaging confirmed splenic infraction and echocardiography revealed vegetation on a bicuspid aortic valve with grade II aortic insufficiency. Blood cultures identified staphylococcus aureus. Initial treatment with ceftriaxone was adjusted to targeted antibiotics but the patient developed an ischemic stroke. After six weeks of therapy aortic valve replacement led to improvement. This case highlights the diagnostic challenge of IE presenting as splenic infraction and the critical role of early echocardiography and blood cultures in febrile patients to prevent severe complications.

 Keywords: Infective Endocarditis; Splenic Infraction; Bicuspid Aortic

1. Hurrell H., et al. “Non-infective endocarditis”. Heart 13 (2020): 1023-1029.
2. O Baguaille., et al. “Une approche pratique de l'infarctus de la rate en tant que manifestation rare de multiples maladies courantes”. Annals of Medicine 6 (2018): 494-500.
3. Maen Mhd Baroudi., et al. “Subacute infective endocarditis presenting with an isolated splenic infarction”. IDCases 32 (2023): e01752.
4. S de Castro., et al. “Précision diagnostique de l'échocardiographie transthoracique et transœsophagienne multiplane pour la perforation valvulaire dans l'endocardite infectieuse aigue: corrélation avec les résultats anatomiques”.
5. Infections à Staphylococcus aureus (infections à Staph).
6. Larry M Bush., et al. “2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM)”. European Heart Journal39 (2023): 3948-4042.