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Abstract Infective endocarditis (IE) poses a diagnostic challenge due to its diverse clinical presentations. We present a case of a 82 year-old female with a history of diabetes mellitus and hypertension who presented with fever, fatigue, and intermittent confusion. Blood cultures revealed Salmonella Typhi, a rare etiology of IE. Transthoracic echocardiography demonstrated vegetations on the aortic valve. Despite prompt initiation of appropriate antimicrobial therapy, the patient deteriorated rapidly. But encountering all the challenges and in view of high surgical risk, patient was managed conservatively and showed gradual clinical improvement. This case report describes a rare and atypical presentation of infective endocarditis (IE) caused by Salmonella Typhi in an elderly female. The case underscores the importance of considering uncommon pathogens in the diagnostic evaluation of endocarditis, particularly when facing clinical challenges. Early recognition and aggressive management are crucial for improving outcomes in such cases.
Koduri et al. (Wed,) studied this question.