Journal of Clinical Cardiology and Diagnostics
Volume 2, Issue 1, 2019, Page No: 1-3

Infective Endocarditis as a Complication of Ventriculoatrial Shunting for Hydrocephalus Treatment

Maja Stefanovic1,2, Aleksandra Milovancev2 , Ilija Srdanovic1,2, Aleksandra Vulin2,3, Aleksandra Ilic2,3, Lazar Velicki4,5, Snezana Tadic2,3, Snezana Bjelic1,2, Tatjana Miljkovic2,3

1.Department of Emergency Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
2. Department of Cardiology, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
3. Department of Internal Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
4. Department of Surgery, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
5. Department of Cardiac Surgery, Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.

Citation : Stefanovic M, Milovancev A, Srdanovic I, Vulin A, Ilic A, Velicki L, Tadic S, Bjelic S, Miljkovic T. Infective Endocarditis as a Complication of Ventriculoatrial Shunting for Hydrocephalus Treatment. J Clin Cardiol Diagn 2019;2(1):1-3.


ABSTRACT

Our aim is to present a rare cause of tricuspid valve infective endocarditis (IE) in grown-up age due to cerebrospinal fluid shuntassociated infection. A 32-year-old woman, with a history of hydrocephalus that was treated with ventriculoperitoneal (VP) shunt at the age of 4, was admitted to a hospital due to fever. The VP shunt was replaced several times due to dysfunction and replaced with ventriculoatrial (VA) shunt 3 months before admission. Transesophageal echocardiogram revealed two separate VA catheters in the right atrium, with two floating echo formations, one attached to the tip of one catheter and the other to the anterior leaflet of tricuspid valve. Blood cultures grew methicillin-susceptible Staphylococcus aureus. Computed tomography scan showed bilateral pneumonia. The patient was treated with antibiotics followed by partial extraction of the VA shunt. After 8 weeks, the patient was discharged, without signs of infection. Two months later, she was readmitted due to fever, echocardiographic signs of catheter infection, and septic pulmonary embolization. Complete extraction of VA catheter was done and treatment was continued with antibiotics with complete recovery. Early diagnosis and optimal management that combines both conventional and surgical approaches is crucial for reducing the high embolic risk, risk of complications, and mortality risk.


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