Manea, M.M.; Dragos, D.; Dobri, A.; Ghenu, M.I.; Enache, I.I.; Stoican, I.C.; Tuta, S. Brainstem Haemorrhage and Amyloid-Like Cerebral Microbleeds Due to Blood Culture-Negative Coxiella burnetii Endocarditis. Preprints2023, 2023070538. https://doi.org/10.20944/preprints202307.0538.v1
APA Style
Manea, M.M., Dragos, D., Dobri, A., Ghenu, M.I., Enache, I.I., Stoican, I.C., & Tuta, S. (2023). Brainstem Haemorrhage and Amyloid-Like Cerebral Microbleeds Due to Blood Culture-Negative Coxiella burnetii Endocarditis. Preprints. https://doi.org/10.20944/preprints202307.0538.v1
Chicago/Turabian Style
Manea, M.M., Iulia Cosmina Stoican and Sorin Tuta. 2023 "Brainstem Haemorrhage and Amyloid-Like Cerebral Microbleeds Due to Blood Culture-Negative Coxiella burnetii Endocarditis" Preprints. https://doi.org/10.20944/preprints202307.0538.v1
Abstract
Infective endocarditis is a rare and challenging diagnosis, Q fever endocarditis being a major cause of culture-negative endocarditis (IE). The presence of multiple cerebral microbleeds (CMBs) suggests a particular vascular frailty and could be correlated to potential emergence of a haemorrhagic stroke in IE. We report a case of a 45 years-old patient with Coxiella burnetii endocarditis, with a brainstem hemorrhage and cerebral MRI CMBs resembling those of CAA. However the systemic inflammatory tests, the splenic infarct and kidney pathology could not be explained by a variant of CAA, neither the normal initial cerebral CT scan when the patient had already the brainstem clinical signs without evidencing the hemorrhage. Transthoracic and transesophageal echocardiogram revealed only calcified bicuspid aortic valve with moderate stenosis and regurgitation, without any vegetations and the blood cultures on conventional media were negative. Serology for Coxiella burnetii was positive. Inclusion of CMBs as a new minor imaging criteria for infective endocarditis could upgrade the diagnosis in almost 50% of patients.
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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