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Case Reports in Medicine
Volume 2018, Article ID 9658120, 3 pages
https://doi.org/10.1155/2018/9658120
Case Report

A Case of Anterior Spinal Artery Syndrome Caused by Streptococcus mitis Endocarditis

1Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
2Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA
3Department of Infectious Disease, Jersey Shore University Medical Center, Neptune, NJ, USA

Correspondence should be addressed to Aria Mahtabfar; ude.sregtur.smjwr@3281ma

Received 2 October 2017; Accepted 26 December 2017; Published 29 January 2018

Academic Editor: Thomas R. Chauncey

Copyright © 2018 Aria Mahtabfar 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

Background. Infectious endocarditis (IE) typically occurs in the setting of intravenous drug use, prosthetic heart valves, or rheumatic heart disease. However, there are a few reports of IE occurring in the setting of immunosuppression secondary to cancer and/or chemotherapy. Here, we present a case of a cancer patient who developed anterior spinal artery (ASA) syndrome secondary to a septic embolus from IE. Case Presentation. A 78-year-old male with a history of gastroesophageal cancer treated with chemotherapy and radiation presented to the hospital after a fall at home. He reported experiencing dyspnea and orthopnea for two weeks prior to presentation. In the ED, his vital signs were stable, and his examination was significant for a flaccid paralysis of the right lower extremity. Diagnosis of septic emboli secondary to IE was made after the echocardiogram showed the presence of vegetations on the aortic valve, blood cultures were positive for Streptococcus mitis, and thoracic spine MRI was indicative of an infarction at T10. Discussion. This case highlights the presence of IE in the setting of cancer and chemotherapy. Although cancer is a rare cause of IE, clinicians must maintain a high index of suspicion in order to minimize the sequelae of IE.