Supravalvular aortotomy infection. Caused by Listeria monocytogenes, masquerading as subacute bacterial endocarditis

Abstract

SUBACUTE infections of a supravalvular aortotomy site are rare and unexpected; such an event, occurring long after surgery and caused byListeria monocytogenes, has never been reported. The following is a case of such a subacute infection occurring in the suture material one and one-half years following an aortotomy performed to relieve a congenital aortic stenosis. The presenting symptoms of this case were those of subarachnoid hemorrhage, with later findings completely consistent with a diagnosis of embolic subacute bacterial endocarditis. Technically, however, the infection was not an endocarditis, but rather a subacute infection of the wall of the aorta. Report of a Case First Admission. —The patient was an 18-year-old white youth with known congenital aortic stenosis which was repaired one and one-half years prior to his admission to the Good Samaritan Hospital, Suffern, NY. The repair was performed by an aortic valvulotomy; the valve was reached through an opening