Gastrointestinal debut of acute staphylococcal endocarditis

Abstract

Staphylococci are now the most common cause of infective endocarditis (IE). The onset of staphylococcal endocarditis (SE) is acute, with high fever, severe intoxication, and therefore, during the initial visit to the doctor, there is an erroneous assumption of influenza, meningitis, hepatitis and other acute diseases. Sometimes the cause of the development of SE remains unclear, the initial clinical manifestations are characterized by high activity of the process, severe general condition of patients, hectic fever, stunning chills, sweats, yellow staining of the skin and mucous membranes, vomiting with blood, leukocytosis, anemia. A clinical case of gastrointestinal SE debut is described with signs of hepatitis and gastric ulcer. Hemorrhages and necrosis of the mucous membrane led to the formation of erosions and ulcers in the antrum and pyloric regions of the stomach, which was manifested by the sudden appearance of severe pain in the abdomen, vomiting with blood. Gastrointestinal manifestations of necrotic vasculitis at the beginning of the SE complicated its timely diagnosis. Hemorrhagic rash was characterized by extensive lesions with the transition to necrosis or suppuration. Cerebral embolism led to multiple brain abscesses, the symptoms of which became leading in the clinical picture. Coronary emboli caused the formation of myocardial abscesses. The use of a chemotherapeutic combination of vancomycin, amikacin and rifampicin with a highly virulent pathogen was ineffective: signs of severe heart damage with perforation of the coronary valve of the aortic valve developed. Progressive multi-organ failure has been fatal.