Endocardite aortique aiguë à Enterococcus faecalis avec multiples emboles septiques périphériques chez un toxicomane de 39 ans

Abstract

Enterococci have emerged in the last decades as a major cause of nosocomial or common infections and Enterococcus faecalis is responsable for 80% of all enterococcal infection. Actually, E. faecalis is the third-most-common cause of bacterial endocarditis overall and predisposing risk factors are the existence of a prosthetic valve, the age, or a previous endocarditis. Among the complications of infective endocarditis, systemic emboli are an ominous prognostic sign. Infective endocarditis still carries high morbidity and mortality rates for the patients requiring intensive care unit admission. The choice and optimal timing depend on many factors like the tolerance of the underlying cardiac disease. Indications for urgent surgical intervention are heart failure, systemic emboli, and uncontrolled sepsis despite a first adequate antibiotic therapy associating aminopenicilline and gentamicine. We report the case of a 39-year-old patient, drug-addict, admitted to the emergency department due a respiratory insuffiency, acute abdominal pain and left brachiofacial palsy and who presented a acute native aortic valve endocarditis with renal, splenic and cerebral emboli and required an urgent mechanical valvular prosthese implantation associating to a right colostomy.