Medicina Kaunas ; 55 6 Jun Article En MEDLINE ID: mdl The case of a year-old male with a recent total gastrectomy for a hemorrhagic gastric tumor is presented, with the important co-morbidities of type II diabetes mellitus requiring insulin, chronic hepatitis C with liver dysfunction, stage II essential hypertension, chronic stage III renal disease peripheral type II aorto-iliac disease with stage II ischemia of both legs, and chronic anemia.
About one month following the gastrectomy, the patient presented with fever and acute inflammatory syndrome. Severe aortic insufficiency, aortic valvular vegetations, and positive blood cultures with Staphylococcus saprophytic were found.
The diagnosis of infectious endocarditis on the aortic valve was established positive blood cultures with echocardiographic features of vegetations, feverand antibiotic treatment with Levofloxacin and Vancomycin was initiated. The evolution was favorable with the remission of the inflammatory syndrome and quick cessation of fever.
However, hpv vaccine mandatory in what states 2020 hemodynamic aspect showed progressive heart failure with acute pulmonary edema.
The coronary angiography revealed double vessel disease. The calculated Euroscore II was Aortic valve replacement with porcine xenograft and double coronary artery bypass graft surgery was performed.
The patient had a favorable postoperative course remaining afebrile and out of heart failure, with the markers of inflammation largely within normal limits. The successful outcome of this case, represented by a rare association of cancer, endocarditis, and coronary disease, reveals the importance of the multidisciplinary teams involved in this case: gastroenterology, general surgery, cardiology, infectious diseases, cardiac surgery, and intensive care.
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Therefore, in such cases with high risk, complex patients, a strong collaboration between all specialties is needed to overcome all of the limitations of the patient's co-morbidities.