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British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 13, Issue.: 2

Case Study

Splenic Rupture after Infective Endocarditis by Enterococcus faecalis: Case Report


Thiago Andrade Macedo1*, Antonio Claudio do Amaral Baruzzi2, Pedro Gabriel de Melo Barros e Silva1, Fabio Quartieri Alves1, Renata Lopes Hames2, Marcio Campos Sampaio1, Jose Carlos Teixeira Garcia2 and Valter Furlan2

1Department of Emergency, Hospital Totalcor, São Paulo, SP, Brazil.

2Intensive Care Unit, Hospital Totalcor, São Paulo, SP, Brazil.

Article Information


(1) Fuhong SU, ICU Laboratory, Erasme Hospital, Free University Brussels, Brussels, Belgium.


(1) Peter Panizzi, Auburn University, USA.

(2) Satesh Bidaisee, St. George’s University, Grenada.

Complete Peer review History: http://sciencedomain.org/review-history/12845


Aims: In patients with infective endocarditis, with risk of embolization, early identification of parenchymal changes may suggest the risk of splenic rupture.

Presentation of Case: A 68-year-old male presented with a history of 2 months of fever and also left upper quadrant pain initiated 2 days before admission. Transesophageal echocardiogram demonstrated the presence of two mobile vegetations on the ventricular side of the aortic valve; the largest diameter being 2.1 cm. Enterococcus faecalis was isolated in blood culture after a diagnosis of subacute aortic valve infective endocarditis. He complained of abdominal pain. An abdominal computed tomography scan revealed infarction of the upper region of the spleen (septic embolism). Therapy with penicillin and gentamicin was initiated, but the patient developed symptoms of heart failure that led to a surgical treatment, and aortic bioprosthesis was implanted on day 14. On day 5 postoperatively, the patient developed sudden hemorrhagic shock signs due to splenic rupture and underwent emergency splenectomy. A pathological examination revealed areas of splenic laceration of the capsule, splenic infarction areas, and the absence of abscesses. Splenic rupture is a complication much rarely occurring due to infectious endocarditis caused by E. faecalis.

Conclusion: This case highlights the importance of conducting serial imaging, particularly in symptomatic patients, for the early detection of parenchymal changes that may suggest the risk of rupture.

Keywords :

Splenic rupture; endocarditis; Enterococcus faecalis; septic embolism.

Full Article - PDF    Page 1-4

DOI : 10.9734/BJMMR/2016/23389

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