Document Detail

Getting to the heart of the matter.
MedLine Citation:
PMID:  17975347     Owner:  NLM     Status:  MEDLINE    
A 60-year-old woman returned from visiting a cousin in Texas. For the past 6 weeks, she had not been feeling well and had lost almost 30 lb. She had frequent night sweats, although she did not recall having taken her temperature. Upon evaluation in the emergency department, results of physical examination were notable for cachexia and poor dentition. She was noted to have pyuria, and therapy was initiated for a urinary tract infection. Results of blood cultures performed the same day were positive for gram-positive cocci, and vancomycin therapy was initiated. She developed difficulty in seeing to her, left and a computed tomographic scan of the brain was performed; results were interpreted as negative. A transesophageal echocardiogram showed a 3-cm mass attached the posterior leaflet of the mitral valve. Initial interpretation was of an atrial myxoma. One of the authors was asked to consult on the case and noted bilateral conjunctival hemorrhages (Figure 1). Subsequently, the blood culture isolate was identified as Streptococcus mitis. Magnetic resonance imaging confirmed multiple cerebral infarcts consistent with embolic origin. The patient underwent emergent cardiac surgery, and her mitral valve was replaced with a bioprosthetic valve. She successfully completed a 4-week course of antibiotic therapy for her endocarditis.
Jack M Bernstein; William Leasure; Allison Buel
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Skinmed     Volume:  6     ISSN:  1540-9740     ISO Abbreviation:  Skinmed     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-02     Completed Date:  2008-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101168327     Medline TA:  Skinmed     Country:  United States    
Other Details:
Languages:  eng     Pagination:  290-2     Citation Subset:  IM    
Wright State University School of Medicine, Dayton, OH, USA.
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MeSH Terms
Conjunctival Diseases / diagnosis,  microbiology*
Endocarditis, Bacterial / microbiology*
Middle Aged
Skin Diseases / diagnosis,  microbiology*
Streptococcal Infections / complications*,  diagnosis
Streptococcus mitis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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