A Complicated Clinical Course of Community-Acquired Staphylococcus aureus Infective Endocarditis

Abstract

Infective endocarditis (IE) is an infection of the heart's endocardial surface, heart valves, or implanted cardiac devices, with the most common causative organism being Staphylococcus aureus. The clinical presentation of IE can be variable, with some patients presenting with multisystemic complications, including renal, pulmonary, cutaneous, and neurologic complications. Cerebral infarction is the most common complication of IE. Here we present a case of a young male with S. aureus IE of a native cardiac valve who developed multiple complications during his clinical course.

Keywords: infective endocarditis; methicillin-sensitive staphylococcus aureus; native valve; neurologic complication; septic embolic stroke; staphylococcus aureus endocarditis.

Figure 1. Macular rash on the palms of the hands (Janeway lesions)

Figure 2. Splinter hemorrhage (red arrow) on the nail of the thumb

Figure 3. A transesophageal echocardiogram showing large vegetations on both the anterior and posterior leaflets

Red arrows indicate valvular vegetation

Figure 4. An image showing red swollen third toe, which occurred during transesophageal echocardiography

Figure 5. Magnetic resonance imaging of the brain showing multiple cerebral infarcts (red arrows)