Abstract
Infectious endocarditis (IE) is a relatively rare but serious condition. We report 3 cases of infectious endocarditis complicated by peri-annular and/or septal abscess. The patients aged 24, 25 and 28 were all male. Global heart failure was observed in 2 cases. Atrioventricular block was noted in 2 cases (complete syncopation: 1 time; 2nd degree Mobitz 2 1 time). Transthoracic echocardiography made it possible to diagnose abscess in all cases (aortic and septal peri-annulus: once, septal only: twice). The aortic insufficiency was grade 2 in all cases, mitral insufficiency grade 2 in 1. The front door was found once, with a dental location. Blood cultures were negative in all cases. A bi-probabilistic antibiotic therapy made it possible to control the infectious process in all the patients. Cardiac surgery, indicated in all cases, was performed in 1 case, consisting of flattening the abscesses and then placing a pacemaker in the patient with complete syncopal atrioventricular block. The outcome of all patients was favorable. Return to permanent sinus rhythm, associated with complete left bundle branch block, was noted at the 4th year of development in the pacemaker wearer. The other 2 patients are still awaiting medical evacuation.
Highlights
Infectious endocarditis (IE) is a relatively rare but serious condition [1]
We report 3 cases of infectious endocarditis complicated by peri-annular and/or septal abscess
Symptoms dated to about five weeks before admission with the gradual onset of NYHA stage II exertional dyspnea that progressed to NYHA stage IV resting dyspnea. It was associated with an oscillating fever with peaks at 40 ̊C, chills and a fatty cough bringing back foamy sputum. These symptoms prompted a visit to a local clinic, where the diagnosis of infectious endocarditis complicated by aortic abscess and heart failure was made
Summary
Infectious endocarditis (IE) is a relatively rare but serious condition [1]. . Heart abscesses in 20% to 30% of cases result from the spread of infection to anatomical structures located in contact with the valves. These abscesses, in particular those which destroy the fibrous valvular rings, constitute an operative difficulty. The germs can be trapped in the fibrous or fibro-calcareous healing tissue This explains certain relapses and recurrences of infectious endocarditis [7]. We report 3 cases of infectious endocarditis complicated by peri-annular and/or septal abscess
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