08 February 2022: Articles
Case Report: Infective Endocarditis of Mechanical Aortic Valve Due to Bacteremia
Unknown etiology, Unusual setting of medical care, Rare disease
Tatiana J. Getman A , Bashar Khiatah C* , Hannah Robinson E , Musab Saeed EDOI: 10.12659/AJCR.933750
Am J Case Rep 2022; 23:e933750
Table 2. Definition of infective endocarditis according to the modified Duke criteria (adapted from Habib et al [8]).
| Definitive IE = 2 Major Criteria and 0 Minor Criteria, or 1 Major Criteria and 3 Minor Criteria, or 0 Major Criteria and 5 MinorCriteriaPossible IE = 1 Major Criteria and 1 Minor Criteria, or 3 Minor Criteria |
| Positive blood culture for typical infective endocarditis organisms ( or bovis, HACEK organisms, without other primary site, Enterococcus), from 2 separate blood cultures or 2 positive cultures from samples drawn >12 h apart, or 3 or a majority of 4 separate cultures of blood (first and last sample drawn 1 h apart) |
| Single positive blood culture for or anti-phase 1 IgG antibody titer >1: 800 |
| Echocardiogram positive for IE: |
| New valvular regurgitation (worsening or changing of pre-existing murmur not sufficient) |
| Abnormal activity around the site of a prosthetic valve detected by PET/CT assuming >3 months after surgery or radiolabeled leukocyte-SPECT/CT |
| Definite paravalvular lesions by cardiac CT |
| Predisposing heart condition or intravenous drug use |
| Temp >38°C (100.4°F) |
| Vascular phenomena (including those detected by imaging alone): arterial emboli, pulmonary infarcts, splenic infarction, mycotic aneurysms, intracranial bleed, conjunctival hemorrhages, Janeway lesions |
| Immunologic phenomena: glomerulonephritis, Osler nodes, Roth spots, rheumatoid factor |
| Microbiological evidence: positive blood cultures not meeting major criterion as noted above or serological evidence of active infection with organism consistent with endocarditis (excluding coag neg staph, and other common contaminants) |
| CT – computed tomography; HACEK – spp., spp., , , spp.; IE – infective endocarditis; IgG – immunoglobulin G; PET – positron emission tomography; SPECT – single-photon emission computed tomography. |