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Case report
Complex case of COVID-19 and infective endocarditis
  1. Katrin Alizadeh1,
  2. Danielle Bucke2 and
  3. Sadia Khan3
  1. 1Haematology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  2. 2Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  3. 3Cardiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Katrin Alizadeh; katrin.alizadeh{at}nhs.net

Abstract

A 50-year-old man with no medical history of note presented with new onset of confusion and dyspnoea. He tested positive for coronavirus (COVID-19), and subsequently, was admitted to the intensive care unit due to severe sepsis and acute renal failure requiring haemodialysis. Shortly afterwards, he was intubated due to haemodynamic instability. His blood culture was positive for Staphylococcus aureus bacteraemia, and echocardiogram showed evidence of vegetation in the aortic valve area. He was commenced on intravenous antibiotics for infective endocarditis (IE). Following extubation, he underwent an MRI of the spine due to increasing back pain. This was suggestive of L5–S1 discitis, likely secondary to septic emboli from IE. A few days later, he developed acute ischaemia of the left toes and extensive thrombosis of the right cubital and left iliac veins. Following a prolonged hospital admission, he was discharged home and later underwent an elective forefoot amputation from which he made a good recovery.

  • cardiovascular medicine
  • venous thromboembolism
  • COVID-19

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bcr-2021-242205

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    Footnotes

    • Twitter @Katrin Alizadeh

    • Contributors KA identified the interesting aspects of the case and looked after the patient, under the supervision of SK. KA and DB studied the case, performed the literature review and drafted the manuscript. KA and SK were responsible for overall supervision of the project. All the authors contributed to, read and agreed with this submission.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.