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Infective Endocarditis Associated with Atopic Dermatitis.

Abstract We report a case of aortic valve infective endocarditis (IE) in a 24-year-old man with atopic dermatitis (AD). He had a history of balloon valvuloplasty for a stenotic bicuspid aortic valve, and had dental caries but no invasive dental procedure before the onset of IE. On admission, skin lesions of AD with itching and scratches were found on the neck, trunk, and extremities. Echocardiography showed a vegetation on the aortic valve with mild steno-regurgitation, but extension of IE to the annulus was not detected. Magnetic resonance imaging identified fresh cerebral infarction without neurological dysfunction, leading us to suspect an embolism. Blood cultures grew methicillin-sensitive Staphylococcus aureus. During emergency surgery, a vegetation attached to the conjoined cusp was observed, and the aortic valve was replaced with a mechanical valve. The patient recovered uneventfully without any complications such as recurrent IE or mediastinitis. We also review previously reported cases of IE associated with AD.
PMID
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Authors

Mayor MeshTerms
Keywords

Embolism

Skin lesion colonization

Staphylococcus aureus

Stroke

Valve disease

Journal Title international heart journal
Publication Year Start




PMID- 29563378
OWN - NLM
STAT- MEDLINE
DCOM- 20180406
LR  - 20180406
IS  - 1349-3299 (Electronic)
IS  - 1349-2365 (Linking)
VI  - 59
IP  - 2
DP  - 2018 Mar 30
TI  - Infective Endocarditis Associated with Atopic Dermatitis.
PG  - 420-423
LID - 10.1536/ihj.17-078 [doi]
AB  - We report a case of aortic valve infective endocarditis (IE) in a 24-year-old man
      with atopic dermatitis (AD). He had a history of balloon valvuloplasty for a
      stenotic bicuspid aortic valve, and had dental caries but no invasive dental
      procedure before the onset of IE. On admission, skin lesions of AD with itching
      and scratches were found on the neck, trunk, and extremities. Echocardiography
      showed a vegetation on the aortic valve with mild steno-regurgitation, but
      extension of IE to the annulus was not detected. Magnetic resonance imaging
      identified fresh cerebral infarction without neurological dysfunction, leading us
      to suspect an embolism. Blood cultures grew methicillin-sensitive Staphylococcus 
      aureus. During emergency surgery, a vegetation attached to the conjoined cusp was
      observed, and the aortic valve was replaced with a mechanical valve. The patient 
      recovered uneventfully without any complications such as recurrent IE or
      mediastinitis. We also review previously reported cases of IE associated with AD.
FAU - Aoyagi, Shigeaki
AU  - Aoyagi S
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
FAU - Oda, Takeshi
AU  - Oda T
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
FAU - Wada, Kumiko
AU  - Wada K
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
FAU - Nakamura, Eiji
AU  - Nakamura E
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
FAU - Kosuga, Tomokazu
AU  - Kosuga T
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
FAU - Yasunaga, Hiroshi
AU  - Yasunaga H
AD  - Department of Cardiovascular Surgery, St. Mary's Hospital.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180320
PL  - Japan
TA  - Int Heart J
JT  - International heart journal
JID - 101244240
SB  - IM
MH  - Dermatitis, Atopic/*complications
MH  - Endocarditis, Bacterial/*diagnosis/*etiology/therapy
MH  - Humans
MH  - Male
MH  - Young Adult
OTO - NOTNLM
OT  - Embolism
OT  - Skin lesion colonization
OT  - Staphylococcus aureus
OT  - Stroke
OT  - Valve disease
EDAT- 2018/03/23 06:00
MHDA- 2018/04/07 06:00
CRDT- 2018/03/23 06:00
PHST- 2018/03/23 06:00 [pubmed]
PHST- 2018/04/07 06:00 [medline]
PHST- 2018/03/23 06:00 [entrez]
AID - 10.1536/ihj.17-078 [doi]
PST - ppublish
SO  - Int Heart J. 2018 Mar 30;59(2):420-423. doi: 10.1536/ihj.17-078. Epub 2018 Mar
      20.