Gonococcal endocarditis: an ever-present threat

Authors

  • Fernando Peixoto Ferraz de Campos Universidade de São Paulo. Hospital Universitário. Internal Medicine Division
  • Vitor Sérgio Kawabata Universidade de São Paulo. Hospital Universitário. Internal Medicine Division
  • Márcio Sommer Bittencourt Universidade de São Paulo. Hospital Universitário. Internal Medicine Division
  • Silvana Maria Lovisolo Universidade de São Paulo. Hospital Universitário. Anatomic Pathology Service
  • Aloísio Felipe-Silva Universidade de São Paulo. Hospital Universitário. Anatomic Pathology Service
  • Ana Paula Silva de Lemos Adolpho Lutz Institute. Bacteriology Center

DOI:

https://doi.org/10.4322/acr.2016.037

Keywords:

Endocarditis, Bacterial, Neisseria gonorrhoeae, Aortic valve, Autopsy

Abstract

The incidence of severe complications of the Neisseria gonorrhoeae infection has presented variations over recent decades since the advent of penicillin. Gonococcal endocarditis (GE) still remains an ever-present threat afflicting the society’s poor and sexually active young population. This entity frequently requires surgical intervention and usually exhibits a poor outcome. The interval between the onset of symptoms and the diagnosis does not usually exceed 4 weeks. One of the characteristics of GE is a proclivity for aortic valve involvement with large vegetation and valve ring abscess formation. The authors report the case of a young man with a 2-week history of fever, malaise, weakness, and progressive heart failure symptoms, who had no previous history of genital complaints or cardiopathy. The physical examination was consistent with acute aortic insufficiency, which was most probably of an infectious origin. The echocardiogram showed thickened aortic cusps and valve insufficiency. After hospital admission, the patient’s clinical status worsened rapidly and he died on the second day. The autopsy findings disclosed aortic valve destruction with vegetation and a ring abscess besides signs of septic shock, such as diffuse alveolar damage, acute tubular necrosis, and zone 3 hepatocellular necrosis. The blood culture isolated N. gonorrhoeae resistant to penicillin and ciprofloxacin. The authors call attention to the pathogen of this particular infectious endocarditis, and the need for early diagnosis and evaluation by a cardiac surgery team

Downloads

Download data is not yet available.

Downloads

Published

2016-06-11

How to Cite

Campos, F. P. F. de, Kawabata, V. S., Bittencourt, M. S., Lovisolo, S. M., Felipe-Silva, A., & Lemos, A. P. S. de. (2016). Gonococcal endocarditis: an ever-present threat. Autopsy and Case Reports, 6(2), 19-25. https://doi.org/10.4322/acr.2016.037

Issue

Section

Article / Autopsy Case Report