Key result
Medical management of Staphylococcus aureus endocarditis in a 47-year-old male with a small Gerbode defect resulted in good recovery without further cardiac complications.
Why the study?
Gerbode defect is a rare cardiac defect predisposing to endocarditis, with limited guidance available on managing small defects complicated by endocarditis without heart failure.
Case Report (n=1)
Medical management of endocarditis without acute surgical closure of a small Gerbode defect can be a successful strategy in patients without evidence of heart failure.
Background Gerbode defect (GD) is a rare cardiac defect in which an abnormal communication occurs between the left ventricle and right atrium. The aetiology is usually congenital but acquired defects can occur. Case summary We report on a 47-year-old male with atrioventricular block prior to decompression of an epidural abscess extending from the skull base to the 7th thoracic vertebrae. Following positive blood cultures for Staphylococcus aureus, a transoesophageal echocardiogram performed revealed a small GD with associated endocarditis. In our case, the defect was small and there was no evidence of heart failure, there was little guidance or literature available on how to best manage our patient. A multidisciplinary decision was taken to treat the endocarditis medically and to not close the defect in the acute setting. He recovered well and did not suffer any further cardiac complications. A repeat transthoracic echocardiogram did not reveal any evidence of endocarditis. Conclusion Gerbode defects are rare but have been known to increase the risk of developing endocarditis. It is important to have a high clinical suspicion of endocarditis in patients with evidence of conduction disorders and systemic infection.
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Liao et al. (2021) conducted a case report in Gerbode defect with associated endocarditis and spinal abscess (n=1). Medical treatment for endocarditis was evaluated on Recovery and cardiac complications. Medical management of Staphylococcus aureus endocarditis in a 47-year-old male with a small Gerbode defect resulted in good recovery without further cardiac complications.
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