Skip to main content Skip to main navigation menu Skip to site footer

Problem diagnostik seorang penderita endokarditis infektif dengan komplikasi perdarahan intrakranial: Sebuah laporan kasus

  • Franky Simarmata ,
  • Ida Bagus Aditya Nugraha ,
  • I Wayan Wita ,
  • Dwijo Anargha Sindhughosa ,

Abstract

Introduction: Infective Endocarditis (IE) is a disease frequently affecting heart valves. The diagnosis is relatively simple, however it could be difficult in unspecific symptoms. Intracranial complications of patients with IE rarely happen.

Case: The case was a 64 years-old male with sudden decrease of consciousness 12 hours prior to admission and diagnosed as a hemorrhagic stroke. He had a history of heavy smoking for about 10 years. Infective Endocarditis (IE) was diagnosed by Duke Criteria, and from this patient we found the vegetation at mitral valve with diameter 1.09 x 0.73 cm. Treatment for the patient is antibiotic according to sensitivity test of blood culture. The patient was discharged with improvement of condition. However, in approximately three months after discharge, the patient got hospitalized again due to the same condition and passed away.

Conclusion: Infective endocarditis is a relatively rare disease. In our case we had a definite IE patient with a spectrum of neurological events complicating this disease. The presence of cerebral hemorrhage complications makes the patient's prognosis worse.

 

 

Pendahuluan: Endokarditis Infektif (IE) merupakan penyakit yang umumnya menyerang katup jantung. Diagnosis pada umumnya relatif sederhana, namun dapat menjadi sulit gejala yang ditemukan tidak spesifik. Komplikasi intrakranial pasien dengan IE jarang terjadi.

Laporan Kasus: Seorang laki-laki 64 tahun dengan penurunan kesadaran mendadak 12 jam sebelum masuk rumah sakit (MRS) dan didiagnosis sebagai stroke hemoragik. Pasien memiliki riwayat perokok berat selama kurang lebih 10 tahun. Endokarditis infektif (IE) di diagnosis dengan kriteria Duke, dan dari pasien ini ditemukan vegetasi pada katup mitral dengan diameter 1,09 x 0,73 cm. Pengobatan untuk pasien adalah antibiotik berdasarkan uji sensitivitas kultur darah. Pasien dipulangkan dengan kondisi perbaikan. Namun, sekitar tiga bulan setelah keluar, pasien kembali dirawat di rumah sakit karena kondisi yang sama dan meninggal dunia.

Simpulan: Endokarditis infektif merupakan penyakit yang relatif jarang. Dalam laporan kasus ini, pasien dengan spektrum kejadian neurologis yang menyulitkan penyakit IE. Adanya komplikasi perdarahan otak membuat prognosis pasien semakin buruk.

References

  1. Klein I, Lung B, Labreuche J, Hess A, Wolff M, Zeitoun D, dkk. Cerebral Microbleeds Are Frequent in Infektive Endocarditis; A Case–Control Study American Heart Association. American Heart Association. 2009;40:3461-3465.
  2. Ebtia M. Infective Endocarditis Revisited: Clinical Manifestations And Echocardiographic Findings of Patients With Infektive Endocarditis. JACC. 2012;59(13):1-5.
  3. Ruttmann E, Willeit J, Ulmer H, Chevtchic O, Hofer D, Poewe W, dkk. Neurological Outcome of Septic Cardioembolic Stroke After Infektive Endocarditis. Stroke. 2006;37:2094-2099.
  4. Grecu N, Tiu C, Terecoasa E, Bajenaru O. Endocarditis and Stroke. Maedica. 2014;9(4): 375-381.
  5. Sila C. Anticoagulation Should Not Be Used in Most Patients With Stroke With Infektive Endocarditis. Stroke. 2011;42:1797-1798.
  6. Hart R, Foster J, Luther M, Kanter M. Stroke in Infektive Endocarditis. Stroke. 1990;21(5):695-700.
  7. Aziz F, Perwaiz S, Penupolu S, Doddi S, Gongireddy S. Intracranial Hemorrhage in Infektive Endocarditis: A case report. J Thorac Dis. 2011;3:134-137.
  8. Liang J, Bishu K, Anavekar S. Infektive Endocarditis Complicated by Acute Ischemic Stroke from Septic Embolus: Successful Solitaire FR Thrombectomy. Cardiol Res. 2012;3(6):277-280.
  9. Kahn D, O’Phelan, Bullock R. Infectious Endocarditis Presenting as Intracranial Hemorrhage in a Patient Admitted for Lumbar Radiculopathy. Hindawi Publishing.2011;10:1-4.
  10. Wahyutomo R. Infektive Endocarditis In 60 Years Old Man At Dr. Kariadi Hospital. Sains Medika. 2013;5(1):45-49.
  11. Hoen B, Beguinot I, Rabaud C, Jaussaud R, Suty C, May T. The Duke Criteria for Diagnosing Infektive Endocarditis Are Specific: Analysis of 100 Patients with Acute Fever or Fever of Unknown Origin. CID. 1996;23:298-302.
  12. Habib G, Hoen B, Tornos P, Thuny F, Prendergast B, Vilacosta I, dkk.; ESC Committee for Practice Guidelines. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the International Society of Chemotherapy (ISC) for Infection and Cancer. Eur Heart J. 2009;30(19):2369-2413.
  13. Hill EE, Herijgers P, Claus P, Vanderschueren S, Herregods MC, Peetermans WE. Infective endocarditis: changing epidemiology and predictors of 6-month mortality: a prospective cohort study. Eur Heart J. 2007;28:196–203 .
  14. Pant S, Patel N, Deshmukh A, Gowala H, Patel N, Badheka A, et al. Trends in Endocarditis Infektive Incidence, Microbiology, and Valve Replacement in the United States From 2000 to 2011. JACC. 2015;65(19):1-7.
  15. Baddour L, Wilson W, Bayer W, Fowler V, Tleyjeh I, Rybaj M. Infective Endocarditis in Adult: Diagnosis, Antimicrobial Therapy, and Management of Complications. JACC. 2015;134(19):1-4.
  16. Baddour L, Wilson W, Bayer A, Fowler V, Bolger A, Levison M. Infective Endocarditis: Diagnosis, Antimicrobial Therapy, and Management of Complications. Circulation. 2005;111(23):394-434.
  17. Masuda J, Yutani, Waki R, Ogata J, Kuriyama Y, Yamaguchi T. Histopathological Analysis of the Mechanisms of Intracranial Hemorrhage Complicating Infektive Endocarditis. Stroke. 1992;23(6): 843-850.
  18. Cooper H, Thompson E, Laureno R, Fuisz A, Mark A, Lin M. Subclinical Brain Embolization in Left-Sided Infektive Endocarditis. Result From the Evaluastion by MRI of the Brains of Patients With Left-Sided Intracardiac Solid Masses (EMBOBOLISM) Pilot Study. Circulation. 2009; 120:585-591.
  19. Wu W, Galin I. Of Life or Limb: The Role of Anticoagulation In Native Valve Endocarditis Infektive. JACC. 2016;67(13):1.

How to Cite

Simarmata, F., Nugraha, I. B. A., Wita, I. W., & Sindhughosa, D. A. (2021). Problem diagnostik seorang penderita endokarditis infektif dengan komplikasi perdarahan intrakranial: Sebuah laporan kasus. Intisari Sains Medis, 12(2), 483–488. https://doi.org/10.15562/ism.v12i2.979

HTML
229

Total
438

Share

Search Panel

Franky Simarmata
Google Scholar
Pubmed
ISM Journal


Ida Bagus Aditya Nugraha
Google Scholar
Pubmed
ISM Journal


I Wayan Wita
Google Scholar
Pubmed
ISM Journal


Dwijo Anargha Sindhughosa
Google Scholar
Pubmed
ISM Journal