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Superior mesenteric artery aneurysm in a patient with infective endocarditis

Published online by Cambridge University Press:  04 March 2015

Jennifer Devon*
Affiliation:
Emergency Department, The Scarborough Hospital, Toronto, ON; Trillium Health Partners – Credit Valley Hospital, Mississauga, ON; and Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON
Philip Miller
Affiliation:
Emergency Department, Lions Gate Hospital, Vancouver, BC
*
Emergency Department, The Scarborough Hospital – General Campus, 3050 Lawrence Avenue East, Toronto, ON M1P 2V5; jennifer.devon@utoronto.ca

Abstract

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Infective endocarditis (IE) is a rare but serious condition. We present a case of endocarditis in a healthy 40-year-old male with no predisposing conditions. His physical examination was suggestive of peripheral microembolization and prompted us to consider the diagnosis of IE and order the appropriate investigations. After treatment, he later presented to the emergency department with abdominal pain, and a superior mesenteric artery aneurysm was discovered. We discuss recent advances in the changing epidemiology and microbiology of IE, review the presentation and diagnosis of IE, and highlight the potential complications of this disease.

Type
Case Report • Rapport de cas
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

References

REFERENCES

1.Habib, G, Hoen, B, Tornos, P, et al (for the European Society of Cardiology Task Force Prevention, Diagnosis and Treatment of Infective Endocarditis). Guidelines on the prevention, diagnosis, and treatment of infective endocarditis. Eur Heart J 2009;30:2369–413, doi:10.1093/eurheartj/ehp285.Google Scholar
2.Murdoch, DR, Corey, R, Hoen, B, et al. Clinical presentation, etiology and outcome of infective endocarditis in the 21st century. Arch Intern Med 2009;169:463–73, doi:10.1001/archinternmed.2008.603.Google Scholar
3.Lomas, JM, Martinez-Marcos, FJ, Plata, A, et al. Healthcareassociated infective endocarditis: an undesirable effect of healthcare universalization. Clin Microbiol Infect 2010;16:1683–90, doi:10.1111/j.1469-0691.2010.03043.x.Google Scholar
4.Benito, N, Miro, JM, de Lazzari, E, et al. Health care–associated native valve endocarditis: importance of nonnosocomial acquisition. Ann Intern Med 2009;150:586–94, doi:10.7326/0003-4819-150-9-200905050-00004.CrossRefGoogle ScholarPubMed
5.Said, K, Rizk, H.Value of adding microscopic hematuria, splenomegaly and high erythrocyte sedimentation rate to modified Duke criteria for the diagnosis of infective endocarditis. Heart Mirror J 2011;5:252–7.Google Scholar
6.Mylonakis, E, Calderwood, SB.Infective endocarditis in adults. N Engl J Med 2001;345:1318–30, doi:10.1056/NEJMra010082.CrossRefGoogle ScholarPubMed
7.Hoen, B, Selton-Suty, C, Lacassin, F, et al. Infective endocarditis in patients with negative blood cultures: analysis of 88 cases from a one-year nationwide survey in France. Clin Infect Dis 1995;20:501–6, doi:10.1093/clinids/20.3.501.CrossRefGoogle ScholarPubMed
8.Osler, W.The Gustonian lectures on malignant endocarditis. Br Med J 1885;1:467–70, doi:10.1136/bmj.1.1262.467.CrossRefGoogle ScholarPubMed
9.Mansur, AJ, Grinberg, M, Leao, PP, et al. Extracranial mycotic aneurysms in infective endocarditis. Clin Cardiol 1986;9:65–72, doi:10.1002/clc.4960090204.CrossRefGoogle ScholarPubMed
10.Friedman, SG, Pogo, GJ, Moccio, CG.Mycotic aneurysms of the superior mesenteric artery. J Vasc Surg 1987;6:8790, doi:10.1067/mva.1987.avs0060087.Google Scholar
11.Ohmi, M, Kikuchi, Y, Ito, A, et al. Superior mesenteric artery aneurysm secondary to infectious endocarditis. J Cardiovasc Surg 1990;31:115–7.Google ScholarPubMed
12.Akkary, E, Cramer, T, Patel, M.Superior mesenteric artery aneurysm: an uncommon disease with potentially serious complications. W V Med J 2010;106:10–4.Google Scholar
13.Chu, PH, She, HC, Lim, KE, et al. Mycotic aneurysm of the superior mesenteric artery in a young woman. Int J Clin Pract 2005;59:614–6, doi:10.1111/j.1368-5031.2005.00526.x.CrossRefGoogle ScholarPubMed
14.Chai, HT, Tan, BL, Yen, HT.Infective endocarditis caused by Streptococcus bovis complicated by a superior mesenteric artery mycotic aneurysm and systemic septic emboli in a patient with colon diverticulitis. Int J Clin Pract 2005;59:614–6, doi:10.1111/j.1368-5031.2005.00526.x.Google Scholar
15.Yüksel, M, Islamoğlu, F, Egeli, U.Superior mesenteric artery aneurysm. Asian Cardiovasc Thorac Ann 2002;10:61–3, doi:10.1177/021849230201000116.CrossRefGoogle ScholarPubMed
16.Stone, WM, Abbas, M, Cherry, KJ, et al. Superior mesenteric artery aneurysms: is presence an indication for intervention? J Vasc Surg 2002;36:234–7, doi:10.1067/mva.2002.125027.Google Scholar
17.Zimmerman-Klima, PM, Wixon, CL, Bogey, WM Jr, et al. Considerations in the management of aneurysms of the superior mesenteric artery. Ann Vasc Surg 2000;14:410–4, doi:10.1007/s100169910074.CrossRefGoogle ScholarPubMed
18.Tolga Muftuoglu, MA, Aktekin, A, Gurleyik, G, et al. A ruptured aneurysm of superior mesenteric artery to duodenum and reconstruction with saphenous vein graft. Eur J Endovasc Surg 2003;25:590–1, doi:10.1053/ejvs.2002.1844.CrossRefGoogle ScholarPubMed
19.Head, SJ, Mokhles, MM, Osnabrugge, RL, et al. Surgery in current therapy for infective endocarditis. Vasc Health Risk Mgmt 2011;7:255–63.Google ScholarPubMed
20.Kim, DH, Kang, DH, Lee, MZ, et al. Impact of early surgery on embolic events in patients with infective endocarditis. Circulation 2010;122(11 Suppl):S1722.Google Scholar
21.Wilson, W, Taubert, KA, Gewitz, M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation 2007;116:1736–54, doi:10.1161/CIRCULATIONAHA.106.183095.Google Scholar