Gonococcal endocarditis: an ever-present threat
The incidence of severe complications of the Neisseria gonorrhoeae infection has presented variations over recent decades since the advent of penicillin. Gonococcal endocarditis (GE) still remains an ever-present threat afflicting the society’s poor and sexually active young population. This entity...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
University of São Paulo
2016-06-01
|
Series: | Autopsy and Case Reports |
Subjects: | |
Online Access: | http://www.revistas.usp.br/autopsy/article/view/125406 |
id |
doaj-8dac793269b64f3aa411c876c54305a6 |
---|---|
record_format |
Article |
spelling |
doaj-8dac793269b64f3aa411c876c54305a62020-11-24T21:22:38ZengUniversity of São PauloAutopsy and Case Reports2236-19602016-06-016210.4322/acr.2016.037Gonococcal endocarditis: an ever-present threatFernando Peixoto Ferraz de Campos0Vitor Sérgio Kawabata1Márcio Sommer Bittencourt2Silvana Maria Lovisolo3Aloísio Felipe-Silva4Ana Paula Silva de Lemos5Universidade de São Paulo. Hospital Universitário. Internal Medicine DivisionUniversidade de São Paulo. Hospital Universitário. Internal Medicine DivisionUniversidade de São Paulo. Hospital Universitário. Internal Medicine DivisionUniversidade de São Paulo. Hospital Universitário. Anatomic Pathology ServiceUniversidade de São Paulo. Hospital Universitário. Anatomic Pathology ServiceAdolpho Lutz Institute. Bacteriology CenterThe incidence of severe complications of the Neisseria gonorrhoeae infection has presented variations over recent decades since the advent of penicillin. Gonococcal endocarditis (GE) still remains an ever-present threat afflicting the society’s poor and sexually active young population. This entity frequently requires surgical intervention and usually exhibits a poor outcome. The interval between the onset of symptoms and the diagnosis does not usually exceed 4 weeks. One of the characteristics of GE is a proclivity for aortic valve involvement with large vegetation and valve ring abscess formation. The authors report the case of a young man with a 2-week history of fever, malaise, weakness, and progressive heart failure symptoms, who had no previous history of genital complaints or cardiopathy. The physical examination was consistent with acute aortic insufficiency, which was most probably of an infectious origin. The echocardiogram showed thickened aortic cusps and valve insufficiency. After hospital admission, the patient’s clinical status worsened rapidly and he died on the second day. The autopsy findings disclosed aortic valve destruction with vegetation and a ring abscess besides signs of septic shock, such as diffuse alveolar damage, acute tubular necrosis, and zone 3 hepatocellular necrosis. The blood culture isolated N. gonorrhoeae resistant to penicillin and ciprofloxacin. The authors call attention to the pathogen of this particular infectious endocarditis, and the need for early diagnosis and evaluation by a cardiac surgery teamhttp://www.revistas.usp.br/autopsy/article/view/125406EndocarditisBacterialNeisseria gonorrhoeaeAortic valveAutopsy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fernando Peixoto Ferraz de Campos Vitor Sérgio Kawabata Márcio Sommer Bittencourt Silvana Maria Lovisolo Aloísio Felipe-Silva Ana Paula Silva de Lemos |
spellingShingle |
Fernando Peixoto Ferraz de Campos Vitor Sérgio Kawabata Márcio Sommer Bittencourt Silvana Maria Lovisolo Aloísio Felipe-Silva Ana Paula Silva de Lemos Gonococcal endocarditis: an ever-present threat Autopsy and Case Reports Endocarditis Bacterial Neisseria gonorrhoeae Aortic valve Autopsy |
author_facet |
Fernando Peixoto Ferraz de Campos Vitor Sérgio Kawabata Márcio Sommer Bittencourt Silvana Maria Lovisolo Aloísio Felipe-Silva Ana Paula Silva de Lemos |
author_sort |
Fernando Peixoto Ferraz de Campos |
title |
Gonococcal endocarditis: an ever-present threat |
title_short |
Gonococcal endocarditis: an ever-present threat |
title_full |
Gonococcal endocarditis: an ever-present threat |
title_fullStr |
Gonococcal endocarditis: an ever-present threat |
title_full_unstemmed |
Gonococcal endocarditis: an ever-present threat |
title_sort |
gonococcal endocarditis: an ever-present threat |
publisher |
University of São Paulo |
series |
Autopsy and Case Reports |
issn |
2236-1960 |
publishDate |
2016-06-01 |
description |
The incidence of severe complications of the Neisseria gonorrhoeae infection has presented variations over recent decades since the advent of penicillin. Gonococcal endocarditis (GE) still remains an ever-present threat afflicting the society’s poor and sexually active young population. This entity frequently requires surgical intervention and usually exhibits a poor outcome. The interval between the onset of symptoms and the diagnosis does not usually exceed 4 weeks. One of the characteristics of GE is a proclivity for aortic valve involvement with large vegetation and valve ring abscess formation. The authors report the case of a young man with a 2-week history of fever, malaise, weakness, and progressive heart failure symptoms, who had no previous history of genital complaints or cardiopathy. The physical examination was consistent with acute aortic insufficiency, which was most probably of an infectious origin. The echocardiogram showed thickened aortic cusps and valve insufficiency. After hospital admission, the patient’s clinical status worsened rapidly and he died on the second day. The autopsy findings disclosed aortic valve destruction with vegetation and a ring abscess besides signs of septic shock, such as diffuse alveolar damage, acute tubular necrosis, and zone 3 hepatocellular necrosis. The blood culture isolated N. gonorrhoeae resistant to penicillin and ciprofloxacin. The authors call attention to the pathogen of this particular infectious endocarditis, and the need for early diagnosis and evaluation by a cardiac surgery team |
topic |
Endocarditis Bacterial Neisseria gonorrhoeae Aortic valve Autopsy |
url |
http://www.revistas.usp.br/autopsy/article/view/125406 |
work_keys_str_mv |
AT fernandopeixotoferrazdecampos gonococcalendocarditisaneverpresentthreat AT vitorsergiokawabata gonococcalendocarditisaneverpresentthreat AT marciosommerbittencourt gonococcalendocarditisaneverpresentthreat AT silvanamarialovisolo gonococcalendocarditisaneverpresentthreat AT aloisiofelipesilva gonococcalendocarditisaneverpresentthreat AT anapaulasilvadelemos gonococcalendocarditisaneverpresentthreat |
_version_ |
1725994826220961792 |