Characteristic | Patient 1* | Patient 2 | Patient 3 | Patient 4 |
---|---|---|---|---|
Age, yr | 48 | 62 | 35 | 33 |
Gender | Male | Male | Male | Male |
Presenting syndrome | Embolization and valvulopathy | Murmur (incidental) | Intracranial hemorrhage (ruptured mycotic aneurysm) | Intracranial hemorrhage (ruptured mycotic aneurysm) |
Valvular involvement | Mitral and aortic | Mitral | Mitral | Mitral |
Previous valvular disease | None | None | Rheumatic heart disease | None |
Diagnostic testing | Serology and 16S from valve tissue | Serology and 16S from valve tissue | Serology | Serology |
Surgical intervention | Valve replacement | Valve replacement | Cerebral artery coiling | No intervention |
Possible exposure | Slept at homeless shelter | Slept at homeless shelter | Slept at homeless shelter, possible ectoparasitosis in rural community | Received meals at homeless shelter, possible ectoparasitosis in rural community |
Links to rural community | No | No | Yes | Yes |
Emergency department presentation within 3 months before hospital admission | Yes | Yes | No | Yes |
Antimicrobial therapy |
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Outcome | Full recovery | Full recovery | Mild neurologic deficits (mild expressive aphasia) | Severe neurologic deficits (paralysis and severe expressive aphasia) |
↵* Patient 1 is the case presented in text.