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...

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Main Authors: Fernando Peixoto Ferraz de Campos, Vitor Sérgio Kawabata, Márcio Sommer Bittencourt, Silvana Maria Lovisolo, Aloísio Felipe-Silva, Ana Paula Silva de Lemos
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
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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
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