A fatal case of infective endocarditis complicated by acute COVID-19 pneumonia.
Anmol PandeyWilliam R DaviesPatrick A CalvertPublished in: Oxford medical case reports (2021)
A 74-year-old man with no co-morbidities presented to hospital with a 3-day history of diarrhoea and vomiting. He met the modified Duke's criteria for definite infective endocarditis and was immediately started on an intravenous antibiotic. Over Days 1-9, he developed renal failure. On Day 10, he was transferred to a tertiary hospital for mitral valve replacement. However, he tested positive for SARS-CoV-2 on arrival at the tertiary hospital, which delayed his surgery. He underwent bi-weekly nasopharyngeal swabs for SARS-CoV-2 with a plan to operate as soon as he tested negative, or as soon as his incubation period for COVID-19 pneumonia had elapsed. Unfortunately, he died on Day 31 from acute respiratory distress syndrome secondary to COVID-19 pneumonia. We describe the challenges in deciding on the optimal timing for valve replacement. We conclude by suggesting that earlier valve replacement may result in better outcomes.
Keyphrases
- sars cov
- mitral valve
- acute respiratory distress syndrome
- respiratory failure
- extracorporeal membrane oxygenation
- respiratory syndrome coronavirus
- coronavirus disease
- mechanical ventilation
- aortic valve
- left atrial
- minimally invasive
- left ventricular
- liver failure
- aortic stenosis
- heart failure
- type diabetes
- metabolic syndrome
- tyrosine kinase
- emergency department
- intensive care unit
- insulin resistance
- coronary artery disease
- aortic dissection
- weight loss