Case Report
Year: 2023 | Month: April-June | Volume: 8 | Issue: 2 | Pages: 472-479
DOI: https://doi.org/10.52403/ijshr.20230261
Challenges in Diagnosing Infective Endocarditis: A Case Report
Ni Kadek Aristia Dewi1, Ketut Erna Bagiari2
1Intern of Cardiologic Department, Sanjiwani Hospital
2Cardiologist of Cardiology Department, Sanjiwani Hospital
Corresponding Author: Ni Kadek Aristia Dewi
ABSTRACT
Introduction: Infective endocarditis (IE) is an infection that affects the endocardial surface of the heart. Enforcing the diagnosis of IE is quite easy, but in some cases, it is sometimes very difficult to suspect the patient is experiencing an IE if the symptoms displayed are atypical or non-specific, so that the diagnosis and treatment are too late
Case illustrations: A 51-year-old man was first referred from a Type C Hospital to the Emergency Room of Type B Hospital with diagnosis of congestive hepatopathy, transaminitis, hyperkalemia, hyponatremia related retention, suspected hypoalbuminemia due to chronic inflammation and hepatopathy, mild normochromic normocytic anemia due to chronic disease, pneumonia, sepsis, AKI (acute kidney injury) with differential diagnose ACKD (acute on chronic kidney disease) because suspect of prerenal suspicion that had been improving. Infective Endocarditis (IE) was diagnosed with modified Duke criteria, in which this patient found vegetation on the aortic valve 1.70 cmx0.66 cm. Treatment for patients was given empirical antibiotics (ampicillin 3 grams every 6 hours by intravenous/IV and gentamicin 180 mg every 24 hours by intravenous/IV) while waiting for blood culture results and the patient was referred to the Central General Hospital/Type A Hospital for further treatment.
Conclusion: Infective Endocarditis is still a challenge in the field of medicine with its low incidence. In this case report, the patient experienced a clinical spectrum that was less specific for IE, causing difficulties in early diagnosis and management
Keywords: Infective Endocarditis, Modified Duke Criteria, Aortic valve