Images in clinical medicine | Volume 39, Article 37, 13 May 2021 | 10.11604/pamj.2021.39.37.29540

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

Salma Kraiem, Hassen Ibn Hadj Amor

Corresponding author: Hassen Ibn Hadj Amor, Department of Cardiology, Taher Sfar Hospital, Mahdia, Tunisia

Received: 27 Apr 2021 - Accepted: 08 May 2021 - Published: 13 May 2021

Domain: Cardiology

Keywords: Bivalvular endocarditis, vegetation, COVID-19

©Salma Kraiem et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Salma Kraiem et al. Bi-valvular endocarditis occurring 2 months after COVID-19 infection. Pan African Medical Journal. 2021;39:37. [doi: 10.11604/pamj.2021.39.37.29540]

Available online at: https://www.panafrican-med-journal.com/content/article/39/37/full

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Images in clinical medicine

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

Salma Kraiem1, Hassen Ibn Hadj Amor1,&

 

1Department of Cardiology, Taher Sfar Hospital, Mahdia, Tunisia

 

 

&Corresponding author
Hassen Ibn Hadj Amor, Department of Cardiology, Taher Sfar Hospital, Mahdia, Tunisia

 

 

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A 60-year-old diabetic man was admitted in cardiology department for dyspnea and fever evolving over 3 weeks with urinary symptoms. In his past history there was a COVID-19 infection that required hospitalization with oxygen therapy for a week and he reported repetitive urinary tract infections. The physical exam showed an axillary temperature at 39.5°c crackling sounds on the lung and no right ventricular failure signs. Laboratory tests showed biologic inflammatory markers elevation; cytobacteriological urine test isolated: enterococcus foecalis and several hemocultures isolated the same named bacteria. Transthoracic echocardiography showed a preserved left ventricular function, a vegetation at the expense of the anterior leaflet of mitral valve (7*4mm); mild mitral valve regurgitation and a huge vegetation at the expense of tricuspid valve (15*20mm) with important tricuspid regurgitation and pulmonary arterial hypertension. The transesophageal echocardiography showed the same vegetation at the expense of the mitral and tricuspid valve and no abnormalities in the other valves. After an initial antibiotic therapy, the patient was referred for surgery in front of worsening mitral insufficiency which has become grade 4.

 

 

Figure 1: A) huge vegetation at the expense of the tricuspid valve in the subcostal window (15*20mm); B) vegetation at the expense of the mitral valve in transesophageal echocardiography (7*4mm); C) vegetation at the expense of the tricuspid valve (15*20mm) in the transesophageal echocardiography (TEE)

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

Images in clinical medicine

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

Images in clinical medicine

Bi-valvular endocarditis occurring 2 months after COVID-19 infection

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