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Case Reports in Cardiology
Volume 2016, Article ID 3793968, 3 pages
http://dx.doi.org/10.1155/2016/3793968
Case Report

Staphylococcus aureus Endocarditis with Multivalvular Involvement Secondary to an Atrial Septal Defect

Conemaugh Memorial Medical Center, Temple University, 1086 Franklin Street, Johnstown, PA 15905, USA

Received 10 November 2015; Accepted 24 January 2016

Academic Editor: Hajime Kataoka

Copyright © 2016 Vistasp Jimmy Daruwalla et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Infective endocarditis is usually diagnosed using modified Duke’s criteria. Our patient had a subacute presentation and a low suspicion for endocarditis during admission, unfortunately leading to her death. Despite advances in diagnostic and therapeutic measures including antibiotic therapy and surgical techniques, morbidity and mortality with staphylococcal infective endocarditis remain high. Hence, we stress the significance of having a low threshold for TEE in patients with multisystem involvement due to Staphylococcus aureus that have evidence of persistent infection despite antibiotic treatment, even if the suspicion for endocarditis is low based on Duke’s criteria. TEE substantially improves the sensitivity of diagnosis but may not be readily available in many medical centers. Presence of an ASD has been noted to have increased the risk of left sided endocarditis even with conditions that predispose to right sided endocarditis, particularly in patients with hemodialysis and diabetes as morbid risk factors.