Infective Endocarditis as a Complication of Crohn's Disease on Immunotherapy

A patient with a history of Crohn's disease on infliximab presented to the hospital with sepsis and a new heart murmur. He was found to have native aortic valve infective endocarditis from a rare species of group D in his blood. The patient was also noted to be in an acute flare of Crohn's...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-12, Vol.14 (12), p.e32847
Main Authors: Singh, Annapoorna, Ejaz, Ain, Gunta, Preetham S, Jakulla, Roopesh Sai, Singh, Daulath
Format: Article
Language:English
Subjects:
Antibiotics
Blood
Cardiology
Case reports
Colonoscopy
Crohns disease
Diuretics
Edema
Endocarditis
Erythema
Heart failure
Immunotherapy
Infectious Disease
Infectious diseases
Inflammation
Inflammatory bowel disease
Internal Medicine
Laboratories
Monoclonal antibodies
Penicillin
Sepsis
Small intestine
Systematic review
Ultrasonic imaging
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Summary:A patient with a history of Crohn's disease on infliximab presented to the hospital with sepsis and a new heart murmur. He was found to have native aortic valve infective endocarditis from a rare species of group D in his blood. The patient was also noted to be in an acute flare of Crohn's disease. The hospital course was complicated by florid heart failure from acute aortic insufficiency. He eventually improved after source control and appropriate antibiotic therapy. bacteremia and endocarditis are attributable to the patient's immunocompromised state as a result of infliximab treatment. While is infrequently grown in blood cultures, it is commonly found in normal gut flora. We hypothesize that it gained access to the bloodstream through the epithelium in the terminal ileum, which was inflamed due to an acute flare of Crohn's disease.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.32847