J Neurocrit Care.  2020 Dec;13(2):101-104. 10.18700/jnc.200019.

Cerebral infarction caused by endocarditis in a patient with COVID-19

• Kwon DH
• Park JS
• Park HJ
• Sohn SI
• Hong JH

• KMID: 2509939
• DOI: http://doi.org/10.18700/jnc.200019

Abstract

Background
Coronavirus disease 2019 (COVID-19) has become a worldwide health threat due to its highly contagious nature and severe complications. The authors experienced a case of cerebral infarction caused by endocarditis in a patient infected with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Case Report
A 65-year-old male patient with COVID-19 was admitted to our hospital for cohort isolation. On day 11 after admission, the patient suddenly presented right-sided hemiparesis. Computed tomography of the brain showed multiple hypodense lesions, which confirmed acute cerebral infarction. Transthoracic echocardiogram revealed a vegetation of about 5 mm on the mitral valve and endocarditis was diagnosed as the cause of cerebral infarction.
Conclusion
Cerebral infarction is one of the complications of COVID-19 and can occur at any time during the course of the disease. Hence, a neurologist has an important role in the medical team involved in COVID-19 treatment.

Keyword

COVID-19; Cardiac injury; Endocarditis; Cerebral infarction; Neurologist

Figure

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  Fig. 1. Findings of brain computed tomography (CT) and transthoracic echocardiogram (TTE). (A, B) Brain CT demonstrates multiple hypodense lesions with surrounding edema in different areas of the brain. (C, D) In the TTE (supine view), a mobile and irregularly shaped echodense mass of approximately 1.0×0.5 cm is attached to the anterior mitral valve (white arrows).

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