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Case report
peer-reviewed

Infective Endocarditis Presenting as Subarachnoid Hemorrhage: An Appeal for Caution



Abstract

Spontaneous subarachnoid hemorrhage (SAH) as the presenting feature of infective endocarditis (IE) is rare. It has classically been described in association with the rupture of intracranial mycotic aneurysms (ICMA). Here we describe a very rare case of non-aneurysmal spontaneous SAH in a patient with IE. The patient originally presented with a headache and low-grade fever. Neuroimaging including computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed SAH. She was eventually diagnosed with streptococcus gallolyticus (formerly streptococcus bovis) IE. Through this case, we advocate consideration of the diagnosis of IE in patients with SAH so that there is timely recognition of this reversible but serious disease.



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Case report
peer-reviewed

Infective Endocarditis Presenting as Subarachnoid Hemorrhage: An Appeal for Caution


Author Information

Talal Asif Corresponding Author

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Amena Mohiuddin

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Badar Hasan

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Amgad Masoud

Department of Internal Medicine, University of Missouri Kansas City (UMKC)


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Infective Endocarditis Presenting as Subarachnoid Hemorrhage: An Appeal for Caution


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Case report
peer-reviewed

Infective Endocarditis Presenting as Subarachnoid Hemorrhage: An Appeal for Caution

  • Author Information
    Talal Asif Corresponding Author

    Department of Internal Medicine, University of Missouri Kansas City (UMKC)

    Amena Mohiuddin

    Department of Internal Medicine, University of Missouri Kansas City (UMKC)

    Badar Hasan

    Department of Internal Medicine, University of Missouri Kansas City (UMKC)

    Amgad Masoud

    Department of Internal Medicine, University of Missouri Kansas City (UMKC)


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: April 19, 2017

    DOI

    10.7759/cureus.1176

    Cite this article as:

    Asif T, Mohiuddin A, Hasan B, et al. (April 19, 2017) Infective Endocarditis Presenting as Subarachnoid Hemorrhage: An Appeal for Caution . Cureus 9(4): e1176. doi:10.7759/cureus.1176

    Publication history

    Received by Cureus: April 10, 2017
    Peer review began: April 13, 2017
    Peer review concluded: April 16, 2017
    Published: April 19, 2017

    Copyright

    © Copyright 2017
    Asif et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Spontaneous subarachnoid hemorrhage (SAH) as the presenting feature of infective endocarditis (IE) is rare. It has classically been described in association with the rupture of intracranial mycotic aneurysms (ICMA). Here we describe a very rare case of non-aneurysmal spontaneous SAH in a patient with IE. The patient originally presented with a headache and low-grade fever. Neuroimaging including computed tomography (CT) and magnetic resonance imaging (MRI) of the head revealed SAH. She was eventually diagnosed with streptococcus gallolyticus (formerly streptococcus bovis) IE. Through this case, we advocate consideration of the diagnosis of IE in patients with SAH so that there is timely recognition of this reversible but serious disease.



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Talal Asif

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

For correspondence:
asift@umkc.edu

Amena Mohiuddin

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Badar Hasan

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Amgad Masoud

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Talal Asif

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

For correspondence:
asift@umkc.edu

Amena Mohiuddin

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Badar Hasan

Department of Internal Medicine, University of Missouri Kansas City (UMKC)

Amgad Masoud

Department of Internal Medicine, University of Missouri Kansas City (UMKC)