Embolic Complications of Infective Endocarditis: Report of Two Cases and Review of National Literature

All classical signs of infective endocarditis (IE) such as fever, a new cardiac murmur, and splenomegaly are rarely found all together. IE should be considered in every patient with unexplained fever. In this report, two patients diagnosed initially as urosepsis and neuro-Beh et’s disease due to embolic complications of infective endocarditis (IE) were presented. A 67-year-old male was admitted to the emergency room with fever, dysuria and flank pain. Both urinary and sequential blood cultures revealed methicillin-sensitive Staphylococcus aureus (MSSA). A 11x6 mm sized mitral valve vegetation was detected on transesophageal echocardiography (TEE). Findings of renal ultrasound were compatible with bilateral pyelonephritis. Mitral valve repair surgery was planned after subsequent TTE controls revealing enlargement of the vegetation. A 45-year-old male with Beh et’s disease was hospitalized in the Department of Neurology because of a speech disorder and weakness on left side of the body for two days, and his blood cultures yielded viridans streptococci. Mobile vegetation on the ventricular surface of the aortic valve and severe aortic regurgitation were detected on TEE. After antibiotic therapy, an aortic valve replacement was performed. Both patients showed an uneventful postoperative course.