Korean J Med.  2014 Jul;87(1):81-86.

Acute Upper Limb Ischemia Suspected to Have Originated from Staphylococcus Epidermidis Native Valve Endocarditis

• Jang SP
• Choi JH
• Yang MJ
• Kim HJ
• Hwang CG
• Kim JH
• Han DH

Abstract

We report a case of acute upper limb ischemia suspected to have originated from methicillin-resistant Staphylococcus epidermidis native valve endocarditis in a 57-year-old man who had complained of sudden-onset fever and pain in the right hand. 3D computed tomography of the right upper extremity detected a thrombus occluding the brachial artery. Echocardiography showed a large vegetation on the aortic valve. Thus, we suspected, clinically, brachial artery occlusion by septic emboli originating from a large vegetation of the aortic valve. The patient was treated with intravenous antibiotics for the suspected methicillin-resistant Staphylococcus epidermidis-native valve endocarditis with a combination of percutaneous aspiration thromboembolectomy and selective intra-arterial thrombolysis for acute thromboembolic occlusion in the right upper limb. The large vegetation of the aortic valve resolved without surgery and aortic regurgitation improved. The patient recovered uneventfully with no complications, including septic embolism, over the following 11 months.

Keyword

Acute lime ischemia; Native valve endocarditis; Staphylococcus epidermides; Thromboembolism

MeSH Terms

Anti-Bacterial Agents
Aortic Valve
Aortic Valve Insufficiency
Brachial Artery
Echocardiography
Embolism
Endocarditis*
Fever
Hand
Humans
Ischemia*
Methicillin Resistance
Middle Aged
Staphylococcus
Staphylococcus epidermidis*
Thromboembolism
Thrombosis
Upper Extremity*
Anti-Bacterial Agents