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International Journal of Case Reports and Images - IJCRI - Case Reports, Case Series, Case in Images, Clinical Images

     
Case Report
 
Fatal outcome in a case of infective endocarditis due to delay in diagnosis and the autopsy findings
Junji Matsuda1,2, Ryo Kojima1, Yutaka Matsumura1, Junichi Nitta1
1MD, Cardiovascular Medicine, Japan Red Cross Saitama Hospital, Saitama, Japan; 2MD, Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan
2MD, Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan

Article ID: Z01201710CR10834JM
doi:10.5348/ijcri-201795-CR-10834

Address correspondence to:
Junji Matsuda
MD, Department of Cardiovascular Medicine
Japan Red Cross Saitama Hospital 1-5
Chuoku Shintoshin, Saitama
330-8553, Japan

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How to cite this article
Matsuda J, Kojima R, Matsumura Y, Nitta J. Fatal outcome in a case of infective endocarditis due to delay in diagnosis and the autopsy findings. Int J Case Rep Images 2017;8(10):627–630.


ABSTRACT

Introduction: Infective endocarditis is an infection of a heart valve or other cardiac structure at a site of endothelial damage. Infective endocarditis is associated with a broad array of complications and has a high fatality rate. Some autopsy case reports regarding causes of death have previously been published. These cases reported that the condition of patients with infective endocarditis worsened drastically, and they suddenly died from fatal complications, such as acute severe heart failure, cerebrovascular major embolism, and hemorrhage or acute coronary embolism. In these cases, early diagnosis did not necessarily have an important role because of the unpredictable and relatively rare situation.
Case Report: A 47-year-old male was transferred to our hospital due to fever and severe fatigue. Although he had been experiencing symptoms for several months and visited doctors near his home several times, his condition was not diagnosed and he took antimicrobial drugs for a few days. On admission, he presented with typical clinical findings of infective endocarditis. Although intensive medical treatment was administered, his severe infection was not controlled, and it led to multi-organ failure. On day-15 of hospitalization, the patient succumbed to multi-organ failure. An autopsy also revealed multi-organ failure.
Conclusion: This case illustrates the fatal outcome of undiagnosed infective endocarditis in a patient who did not have fatal complications, such as acute heart failure, cerebrovascular major embolism, and hemorrhage or acute coronary embolism, which have been reported in past cases. In this case, early diagnosis could have avoided the unfortunate outcome. We report this case to emphasize the importance of early diagnosis of infective endocarditis.

Keywords: Autopsy, Early diagnosis, Infective endocarditis, Multi-organ failure



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Acknowledgements
We would like to thank Editage for English language editing.

Author Contributions
Junji Matsuda – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ryo Kojima – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Yutaka Matsumura – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Junichi Nitta – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guarantor
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Junji Matsuda et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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