To Look for a Needle in the Haystack: An Uncommon Cause of ...
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Citation: Berlot G, Tomasini A, Roman-Ponuz E, Bussani R. To Look for a Needle in the Haystack: An Uncommon Cause of Endocarditis. Austin J Emergency & Crit Care Med. 2019; 5(1): 1068. Austin J Emergency & Crit Care Med - Volume 5 Issue 1 - 2019 ISSN : 2380-0879 | www.austinpublishinggroup.com Berlot et al. © All rights are reserved Austin Journal of Emergency and Critical Care Medicine Open Access Clinical Image A 39/year/old man with a long-term history of iv. drug abuse was admitted to our ICU in coma. At the brain CT-scan, multiple bilateral hypodensities were present and a Trans-Esophageal Echocardiography (TEE) demonstrated a massive endocarditis involving the tricuspid, the aortic and the mitral valves. He died 3 days later due to the occurrence of a multiple organ failure. At the Clinical Image To Look for a Needle in the Haystack: An Uncommon Cause of Endocarditis Berlot G 1 *, Tomasini A 1 , Roman-Ponuz E 1 , Bussani R 2 1 Department of Anesthesia and Intensive Care, University of Trieste, Italy 2 Department of Pathological Anatomy, University of Trieste, Italy *Corresponding author: Giorgio Berlot, Department of Anesthesia and Intensive Care, Cattinara Hospital, Strada di Fiume 447, University of Trieste, Italy Received: November 25, 2019; Accepted: December 28, 2019; Published: December 31, 2019 Figure 1: Massive tricuspidal end ocarditis and septal penetrating abscess. Figure 2: Panel A: Interventricular abscess and necrotic area (white arrow) where the needle (blue arrow) (B) was located. Panel B: The retrieved needle. autopsy, septic embolus’s were found in all organs; the examination of the heart not only confirmed the TEE findings (Figure 1) but a 15mm-long distal part of a needle was retrieved from the right side of the interventricular septum causing an abscess penetrating in the leſt ventricle which caused the leſt-sided endocarditis (Figure 2). e admission imaging were reviewed by physicians other than those involved in the initial evaluation and unaware of the correct diagnosis but again the foreign body was not identified likely due its small size.
Transcript of To Look for a Needle in the Haystack: An Uncommon Cause of ...
Citation: Berlot G, Tomasini A, Roman-Ponuz E, Bussani R. To Look for a Needle in the Haystack: An Uncommon Cause of Endocarditis. Austin J Emergency & Crit Care Med. 2019; 5(1): 1068.
Austin J Emergency & Crit Care Med - Volume 5 Issue 1 - 2019ISSN : 2380-0879 | www.austinpublishinggroup.com Berlot et al. © All rights are reserved
Austin Journal of Emergency and Critical Care Medicine
Open Access
Clinical ImageA 39/year/old man with a long-term history of iv. drug abuse
was admitted to our ICU in coma. At the brain CT-scan, multiple bilateral hypodensities were present and a Trans-Esophageal Echocardiography (TEE) demonstrated a massive endocarditis involving the tricuspid, the aortic and the mitral valves. He died 3 days later due to the occurrence of a multiple organ failure. At the
Clinical Image
To Look for a Needle in the Haystack: An Uncommon Cause of EndocarditisBerlot G1*, Tomasini A1, Roman-Ponuz E1, Bussani R2
1Department of Anesthesia and Intensive Care, University of Trieste, Italy2Department of Pathological Anatomy, University of Trieste, Italy
*Corresponding author: Giorgio Berlot, Department of Anesthesia and Intensive Care, Cattinara Hospital, Strada di Fiume 447, University of Trieste, Italy
Received: November 25, 2019; Accepted: December 28, 2019; Published: December 31, 2019
Figure 1: Massive tricuspidal end ocarditis and septal penetrating abscess.
Figure 2: Panel A: Interventricular abscess and necrotic area (white arrow) where the needle (blue arrow) (B) was located. Panel B: The retrieved needle.
autopsy, septic embolus’s were found in all organs; the examination of the heart not only confirmed the TEE findings (Figure 1) but a 15mm-long distal part of a needle was retrieved from the right side of the interventricular septum causing an abscess penetrating in the left ventricle which caused the left-sided endocarditis (Figure 2). The admission imaging were reviewed by physicians other than those involved in the initial evaluation and unaware of the correct diagnosis but again the foreign body was not identified likely due its small size.
