An Atypical Presentation of Gonococcal Endocarditis

Abstract

A 53-year-old male presented following cardiac arrest, followed by cardiopulmonary resuscitation. He was found to have myocardial infarction, bihemispheric cerebral embolization and mitral valve endocarditis. Mitral valve replacement was performed and Neisseria gonorrhoeae was detected on PCR. This case represents a valuable addition to the limited reports on gonococcal endocarditis.

Keywords: Neisseria gonorrhoea; cerebral embolization; endocarditis; valve replacement.

Graphical abstract

Figure 1

Diffusion-Weighted Magnetic Resonance Image of Brain Gyriform enhancement in the right frontal lobe and small enhancement of the right precentral gyrus suggestive of bihemispheric cerebrovascular infarcts.

Figure 2

Transthoracic Echocardiogram Parasternal long-axis view (left) with a large vegetation (25 × 10 mm) visible on the anterior mitral valve leaflet and severe mitral regurgitation seen on color Doppler view (right).

Figure 3

Cardiac Catheterization Cardiac catheterization with procedure image demonstrating complete occlusion of the distal portion of the second obtuse marginal branch of the left circumflex artery (red arrow).

Figure 4

Intraoperative Image Anterior leaflet of the mitral valve with a large vegetation (25 ×10 mm) exposed via a superior trans-septal approach (surgeon’s view).