Aortic Endocarditis on Bicuspid Valve Complicated by Valvular Perforation and Severe Aortic Regurgitation due to Methicillin-resistant Staphylococcus aureus: A Case Report
Résumé
Infective endocarditis (IE) on a bicuspid aortic valve (BAV) is a severe condition associated with high morbidity and mortality rates despite diagnostic and therapeutic advances. We report the case of a 25-year-old patient admitted with prolonged fever, exertional dyspnea, and marked asthenia, who was diagnosed with complicated aortic endocarditis. Echocardiography revealed a type 0 bicuspid valve with perforation of the anterior cusp, leading to severe aortic regurgitation. Serial blood cultures identified methicillin-resistant Staphylococcus aureus (MRSA). Intravenous vancomycin therapy was urgently initiated, followed by aortic valve replacement with a mechanical prosthesis. The postoperative course was favorable, with complete resolution of the infectious syndrome and proper prosthetic function. This case highlights the importance of early diagnosis and prompt medical-surgical management in the face of severe complications of IE on BAV.