Marietta L. Juan-Guardela, Servicio de Cardiología, Clínica Neurodinamia S.A.S, Cartagena, Colombia
Omar E. Castilla-Romero, Unidad de Cuidados Intensivos, Clínica Neurodinamia S.A.S, Cartagena, Colombia
Antonio J. Oyola-Yepes, Unidad de Cuidados Intensivos, Clínica Neurodinamia S.A.S, Cartagena, Colombia
Camilo A. Arango-Echeverri, Programa de Especialización de Medicina Crítica y Cuidado Intensivo, Universidad del Sinú, Cartagena, Colombia
Luis E. Calderón-Castellón, Programa de Especialización de Medicina Crítica y Cuidado Intensivo, Universidad del Sinú, Cartagena, Colombia
Infective endocarditis (IE) is a severe condition that may initially present with neurological complications. Early recognition and timely management are essential to improve clinical outcomes. It is reported the case of a patient with native-valve IE complicated by an ischemic cerebrovascular event, integrating diagnostic imaging and standardized clinical criteria. A 58-year-old man with a history of prostate adenocarcinoma presented with acute neurological deficits. Magnetic resonance imaging showed a right medullary infarction, and echocardiography demonstrated severe aortic regurgitation with valvular vegetations fulfilling modified Duke criteria. Targeted beta-lactam therapy was initiated with multidisciplinary monitoring. Due to the ischemic neurological event, surgical intervention was deferred to reduce the risk of intracranial hemorrhage. Aortic valve replacement was performed during the fifth week, with favorable postoperative recovery. IE complicated by ischemic stroke represents a therapeutic challenge, particularly regarding the timing of surgery. Coordinated management involving cardiology, neurology, infectious diseases and cardiovascular surgery is essential to optimize outcomes in patients requiring delayed surgical intervention.
Keywords: Aortic insufficiency. Infective endocarditis. Stroke. Streptococcus anginosus. Valve vegetations. Valve surgery.
