Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of subarachnoid hemorrhage due to infective endocarditis by methicillin-resistant coagulase-negative staphylococcus

Shunsuke Kajikawa, M.D.1), Tomoko Oeda, M.D., Ph.D.1), Kwiyoung Park, M.D.1), Kenji Yamamoto, M.D., Ph.D.1), Hiroshi Sugiyama, M.D., Ph.D.1) and Hideyuki Sawada, M.D., Ph.D.1)

1)Department of Neurology, Utano Hospital, National Hospital Organization

A 77-year-old man visited our hospital with unstable gait following 2 months of anorexia. Brain MRI showed multiple infarcts; cardiac echocardiography revealed mitral-valve vegetation; and blood culture revealed methicillin-resistant coagulase-negative staphylococci. The patient was diagnosed with infective endocarditis (IE). Subarachnoid hemorrhage (SAH) developed ten days after antibiotic treatment. Intracranial aneurysm was not found. We speculated that chronic inflammation of the cerebral arterial walls by bacteria of low virulence was associated with SAH complication. The vegetation disappeared following additional gentamicin administration and the patient recovered to walk.
Full Text of this Article in Japanese PDF (481K)

(CLINICA NEUROL, 57: 775|777, 2017)
key words: infective endocarditis, subarachnoid hemorrhage, mycotic aneurysm, vegetation, MRCNS

(Received: 8-May-17)