Aortic valve endocarditis with aortic wall thickening requires close follow-up for a possible abscess formation

Perfusion. 2009 Jan;24(1):33-5. doi: 10.1177/0267659109105982.

Abstract

A 67-year-old woman was admitted with aortic valve endocarditis and aortic wall thickening (AWT). Physical examination and laboratory findings yielded infective endocarditis. Echocardiography revealed several small vegetations on the aortic valve, leading to moderate aortic insufficiency together with a small ventricular septal defect. We also became aware of the AWT on and over the aortic root by transesophageal echocardiography (Figure 1). At the one month follow-up period, we also noticed an abscess formation originating from the AWT, which grew into a mature abscess form, day by day (Figure 2). The aortic valve endocarditis, with destruction of the aortic annulus and abscess formation, in this patient, is considered as a grave condition which, essentially, requires an aggressive combined surgical and medical approach. We would like to intimate here with this patient that AWT needs to be considered seriously important in aortic valve endocarditis and, even if the detected vegetations are small, a close follow-up for a possible abscess formation is essential.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging*
  • Abscess / pathology
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / microbiology
  • Aortic Valve / pathology*
  • Aortic Valve / surgery*
  • Aortic Valve Insufficiency / diagnostic imaging
  • Aortic Valve Insufficiency / microbiology
  • Aortic Valve Insufficiency / pathology
  • Aortic Valve Insufficiency / surgery
  • Ceftriaxone / therapeutic use
  • Endocarditis, Bacterial / diagnostic imaging*
  • Endocarditis, Bacterial / drug therapy
  • Endocarditis, Bacterial / microbiology
  • Endocarditis, Bacterial / surgery
  • Female
  • Gentamicins / therapeutic use
  • Heart Valve Prosthesis Implantation
  • Humans
  • Penicillin G / therapeutic use
  • Staphylococcal Infections / diagnostic imaging
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology
  • Staphylococcal Infections / surgery
  • Streptococcus / isolation & purification*
  • Ultrasonography

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Ceftriaxone
  • Penicillin G