Many Faces of Infective Endocarditis- Radiological Features of Extracardiac Complications.

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2014

Poster Number:

C-0923

Type:

Educational Exhibit

Keywords:

Infection, Acute, Abscess, Complications, MR, Echocardiography, CT, Vascular, Cardiovascular system, Cardiac

Authors:

M. Elsayed, M. Chiphang; Wigan/UK

DOI:

10.1594/ecr2014/C-0923

DOI-Link:

https://dx.doi.org/10.1594/ecr2014/C-0923

Fig. 7: Axial contrast enhanced CT scan of the abdomen in Portal venous phase showing...

Fig. 8: Coronal reformat of two different patients as figure (6), demonstrating the...

Fig. 10: CT coronal reformatted portal venous phase scan of two different patients....

Fig. 1: Axial FLAIR (A), DWI(B) and corresponding ADC map (C). (A) Showing abnormal...

Learning objectives

Extracardiac complications of IE can precede the clinical diagnosis of IE. It is therefore important that the diagnosis is suggested when a Radiologist is faced with typical and unusual imaging findings. Pictorial review demonstrating extracardiac complications of IE. Discuss clinical and radiological clues to aid prompt diagnosis.

Background

IE is a microbial infection of the endocardium and heart valves, most commonly by bacteria. Although the primary focus of the infection is confined to the endocardium, microbial shedding by continuous bacteremia and embolization of vegetation fragments makes IE a true systemic infection. Incidence ranges from 2-5 cases per 100,000 per annum. Historically, chronic rheumatic heart disease was the primary risk factor, but in the recent years new risk groups have emerged. IE is a serious systemic infection with multiple cardiac and extracardiac manifestations. It...

Findings and procedure details

A Pictorial review of extracardiac radiological manifestations. Examples Include: CNS: Brain infarction. Larynx: Ortner’s Syndrome Lung: Septic pulmonary emboli, pneumonia Spleen: Splenic infarcts, splenic abscess Liver: Liver abscess Kidney: Renal Infarcts. Musculoskeletal: Discitis Vascular: Mycotic aneurysms, infected femoral vein thrombus. CNS:Brain infarcts Larynx:Ortner’sSyndrome. Lung: Septic pulmonary emboli, pneumonia. Cardiovascular:Vegitation/ Mural Thrombus. Spleen:Splenic infarct, abscess. Renal:Renal infarcts. Liver:Liver abscess. Musculoskeletal: Discitis Vascular: Mycotic aneurysms, infected femoral vein thrombus.

Conclusion

Infective endocarditic is a potentially life threatening disease with associated mortality. Although echocardiography remains to be the gold standard in the diagnosis of IE, many extracardiac radiological imaging features offer invaluable clues that aids in prompt diagnosis and effective treatment.

Personal information

References

C. Prados, C. Carpio, A. Santiago, I. Silva and R. Álvarez-Sala (2012). Radiology in Infective Endocarditis, Endocarditis, Prof. Francisco Ramón Breijo-Márquez (Ed.), ISBN: 978-953-307-901-1. Colen TW,Gunn M, Cook E, Dubinsky T, Radiological Manifestations of Extra-cardiac complications of infective endocarditic: Eur Radiol.2008 Nov;18 (11):2433-45.Doi:10.1007/s00330-008-1037-3. Epub 2008 jun 4. Davidson, principles and practice of medicine, 19th edition.