Abstract:
Infective endocarditis (IE) is the endovascular microbial infection of cardiovascular structures (cardiac valve, ventricular or atrial endocardium) including endarteritis of large intrathoracic vessels.1,2 Orthopedic diseases, particularly spondylodiscitis and osteomyelitis are frequently associated with infective endocarditis and prevalence varies between 3.7-15%. Diabetic foot infection is a complication which develops as the result of peripheral neuropathy and insufficient tissue perfusion, proceeds to deeper tissues unless treated and impairs the quality of life of the patients, even it may be life-threatening. S.aureus and beta-hemolytic streptococcus are the most commonly isolated bacteriae.3 CASE REPORT A 57-year-old male patient with purulent foot wound in the sole for 9 years was admitted to our clinic with complaints of fever elevating with shivering, low back pain, musculoskeletal pain, fatigue, loss of appetite. The patient stated that his wound did not recover despite treatment with various antibiotics. His back pain had been continued for 2 weeks. On his medical history, he had diabetes mellitus for 10 years and hypertension for 5 years. Arterial blood pressure was 178/95 mmHg, with 1-2/6 systolic murmur, his 2nd and 3rd toe fingers had been amputated. He had a purulent diabetic foot ulcer with a profound tissue loss on his sole. His laboratory findings were as follows: white blood cell count 23400 (neutrophil88%), CRP 197mg/l, erythocyte sedimentation rate (ESR) 83 mm/h. Piperacillin/tazobactam and daptomycin treatment was started. Thoracolumbar MRI obtained for low back pain revealed paraver tebral abscess in corpus of T10-11 spines consistent with spondylodiscitis. MRSA grew in smear culture and MRSA grew in blood culture. Dyspnea, tachypnea, orthopnea and fever developed. However CRP and leucocyte count regressed on day 3 of treatment.
Page(s):
88-90
DOI:
DOI not available
Published:
Journal: Pakistan Heart Journal, Volume: 49, Issue: 2, Year: 2016