Naslov
Development of infective endocarditis with a lethal outcome in a patient with septic shock caused by MRSA: a case report

Autori
Delalić, Điđi ; Nesek Adam, Višnja

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, pp prezentacija, stručni

Skup
45th SYMPOSIUM OF INTENSIVE MEDICINE

Mjesto i datum
Zagreb, Hrvatska, 01.12.2022. - 03.12.2022

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Recenziran

Ključne riječi
Infective Endocarditis ; MRSA ; Sepsis

Sažetak
Introduction Infective endocarditis (IE) is a disease with an incidence of 3-5 per 100 000 individuals and a high rate of morbidity and mortality. Case description A 67-year-old male patient with multiple comorbidities was admitted to the ICU due to respiratory insufficiency during induction into general anesthesia for the amputation of the left foot due to cuboid bone osteomyelitis caused by MRSA. The patient was intubated and mechanically ventilated on admission, hemodinamically unstable with vasoactive and inotropic support instituted. Due to the sepsis caused by MRSA, source control was performed by amputating the patient’s left shin. Further diagnostic evaluation revealed lung atelectasis and a pericardial effusion. Laboratory diagnostic tests showed increased concentrations of inflammatory markers and a coagulation disorder. An echocardiographic exam was performed, revealing tricuspid valve endocarditis. Following the sampling for hemocultures, the patient was started on antibiotic therapy for endocarditis, which resulted in a decrease in inflammatory markers. On the ninth day following the amputation, the patient went into cardiac arrest and expired despite the cardiopulmonary resuscitation measures provided. Discussion Infection with Staphylococcus aureus leads to IEs through the pathogen’s manipulation of the host’s innate immunity and coagulation cascade. Population studies have shown that S. aureus is the most common isolated pathogen in hemoculture samples acquired from ICU patients suffering from IE. Conclusion Clinicians should be aware of the possibility of patients with sepsis caused by MRSA developing IE and be on the lookout for signs of IE in order to diagnose it early and begin optimal treatment.

Izvorni jezik
Engleski

Znanstvena područja
Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

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