Culture Negative Infective Endocarditis Atypically Diagnosed From Mycotic Cerebral Aneurysm.

Autor:	Khalafi S; Internal Medicine, Texa Tech University Health Sciences Center El Paso, El Paso, USA., Reddy S; Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA., Togra A; Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA., Gupta K; Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA., Borges JC; Cardiovascular Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jun 06; Vol. 16 (6), pp. e61856. Date of Electronic Publication: 2024 Jun 06 (Print Publication: 2024).
DOI:	10.7759/cureus.61856
Abstrakt:	Cerebral mycotic aneurysms (CMA) are a rare consequence of infective endocarditis (IE). We report a case of a 75-year-old left-handed male with comorbidities who was admitted to our facility with left-sided weakness, dysarthria, and left-sided facial droop. Initial computed tomography of the head without contrast and angiography of the head showed acute hemorrhage in the paramedian right frontal lobe with extension into the right lateral ventricle, occlusion of the left intracranial internal carotid artery, and an associated 0.3 cm aneurysm involving the distal right anterior cerebral artery. C-reactive protein and erythrocyte sedimentation rate were elevated but blood cultures showed no growth for more than five days. The patient underwent a two-vessel cerebral angiogram, primary coil embolization of the aneurysm, and selective catheterization of the left common carotid artery, right internal carotid artery, and right anterior cerebral artery. Transesophageal echocardiography showed an echogenic, highly mobile structure attached to the aortic valve suggestive of vegetation. The patient was subsequently started on a vancomycin regimen and stably discharged for further outpatient follow-up. This case highlights an uncommon presentation of CMA and the retroactive diagnosis of IE. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Khalafi et al.)
Databáze:	MEDLINE
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