Posters
Presenting Author Academic/Professional Position
Bhargavi Akkineni
Academic Level (Author 1)
Medical Student
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
A 80 year old woman, with a past medical history of aortic stenosis status post TVAR, sick sinus syndrome with permanent pacemaker placement, and hypertension, presented to ED with generalized body weakness and persistent fevers with an onset of three days. On physical exam, patient was tachypneic, tachycardic, febrile, and she exhibited a motor strength of 1/5 in her left upper extremity with intact motor strength in all other extremities. CT of head revealed chronic small vessel ischemic changes, and an MRI of the head, obtained consequently, depicted multifocal bilateral supratentorial acute infarcts. Patient’s physical findings also prompted for blood cultures; they were positive for gram positive cocci and patient was started on an empiric therapy of Vancomycin and Zosyn. Patient was suspected to be at high risk for developing infective endocarditis, so she underwent a TTE the following day, which revealed no abnormalities, but two days later, she underwent a TEE, which did reveal a small nodular density on the prosthetic valve. The blood cultures were positive for MSSA, and patient’s IV antibiotics were adjusted to Oxacillin and Rifampin. Within 24 hours, blood cultures were negative, and patient was scheduled to continue her IV antibiotic regimen for upwards of 6 weeks. In the following days, patient’s left upper extremity weakness resolved, but she developed characteristic Janeway lesions on the soles of her feet. A repeat TEE revealed a small nodular density attached to the prosthetic valve; however, it was larger in size than the nodular density seen in the previously done TEE. Patient was planned for emergent surgical intervention; however, she developed pulseless electrical activity and resuscitation efforts were not successful.
Presentation Type
Poster
Recommended Citation
Akkineni, Bhargavi and Lopez, Gabriel, "A Case of Infective Endocarditis in Aortic Stenosis Status Post TVAR" (2025). Research Colloquium. 63.
https://scholarworks.utrgv.edu/colloquium/presentation/poster/63
Included in
A Case of Infective Endocarditis in Aortic Stenosis Status Post TVAR
A 80 year old woman, with a past medical history of aortic stenosis status post TVAR, sick sinus syndrome with permanent pacemaker placement, and hypertension, presented to ED with generalized body weakness and persistent fevers with an onset of three days. On physical exam, patient was tachypneic, tachycardic, febrile, and she exhibited a motor strength of 1/5 in her left upper extremity with intact motor strength in all other extremities. CT of head revealed chronic small vessel ischemic changes, and an MRI of the head, obtained consequently, depicted multifocal bilateral supratentorial acute infarcts. Patient’s physical findings also prompted for blood cultures; they were positive for gram positive cocci and patient was started on an empiric therapy of Vancomycin and Zosyn. Patient was suspected to be at high risk for developing infective endocarditis, so she underwent a TTE the following day, which revealed no abnormalities, but two days later, she underwent a TEE, which did reveal a small nodular density on the prosthetic valve. The blood cultures were positive for MSSA, and patient’s IV antibiotics were adjusted to Oxacillin and Rifampin. Within 24 hours, blood cultures were negative, and patient was scheduled to continue her IV antibiotic regimen for upwards of 6 weeks. In the following days, patient’s left upper extremity weakness resolved, but she developed characteristic Janeway lesions on the soles of her feet. A repeat TEE revealed a small nodular density attached to the prosthetic valve; however, it was larger in size than the nodular density seen in the previously done TEE. Patient was planned for emergent surgical intervention; however, she developed pulseless electrical activity and resuscitation efforts were not successful.
