Nervous system complications in bacterial endocarditis

摘要: Abstract Neuropsychiatric complications are common in bacterial endocarditis, and if sought for may be found up to 40 50 per cent of patients. The nervous system is involved as frequently the present era decades prior introduction antibiotics. Any acute neurologic syndrome or psychiatric illness arising a patient with fever cardiac murmur absence arrhythmia should suggest endocarditis. Complications mainly due infected emboli; meningoencephalitis most complication, but overt embolus mycotic aneurysm not rare. Brain abscesses more complication than subacute endocarditis; antibiotic has seen an apparent decline incidence this complication. Other, less well characterised, pathologic include cerebral micro-infarcts, purpura edema endarteritis thrombosis stenosis. A wide range presentations can result from lesions, dramatic being hemiplegia, aphasia, cranial nerve paralysis, hemorrhage subarachnoid hemorrhage. relatively minor symptoms, such headache confusion, portend serious outcome. cerebrospinal fluid shows abnormalities following embolisation brain. Although usual finding sterile meningitis, underlying lesion present: particular, meningitis few no red blood cells appearing fluid. Full investigation during course endocarditis angiography. since aneurysms resected. Management does not, general, require any departure treatment neurosurgical intervention required abscesses.