Yu Gao*, Peipei Huang**, Yong Mei**,#, Wei Li**, Xufeng Chen**, Jinsong Zhang**


*Changshu Hospital Affiliated to Soochow University, First People's Hospital of Changshu City, Emergency center, Changshu 215500, Jiangsu Province, China - **Jiangsu People's Hospital, Emergency center, 210000, Jiangsu Province, China


Objective: Infective endocarditis (IE) is a disease that causes acute and subacute inflammation in endocardium, valves or intima of adjacent great artery directly infected by pathogenic microorganisms entering the blood. Microorganisms are primarily bacteria, which are mostly staphylococcus aureus in the acute stage and viridans streptococcus in the sub-acute stage. IE sometimes has insidious onset, often with atypical clinical manifestations in the elderly and patients in immunosuppressive status, lacking specificity, so such patients are often admitted to related specialist clinic due to symptoms like fatigue, decreased appetite and weight loss, which can easily lead to misdiagnosis and missed diagnosis.

Methods: Method of this study designe din 3 stages: Stage one: A 74-year-old woman was admitted to the Orthopaedics Department of Jiangsu Provincial People's Hospital on December 10, 2018 due to "30 years of low back pain aggravated with 15 days of left lower extremity pain. Stage two: physical examination after admission to the EICU showed: shallow coma, T 37.3℃, BP86/50 (NE 2.0mcg/min/kg maintenance), GCS E1VtM5, no yellowish stains, petechiae, ecchymosis on the body skin, and finally Stage three: On the 3rd day after admission, cyanosis gradually appeared in the tip of left little finger, which was considered as detachment of bacterial embolism from the embolus to proper arterial embolism of little finger tip. 

Results: This paper reports a recent case diagnosed as IE after transfer to our department in which the patient was admitted to orthopedics department due to low back pain, but deteriorated during hospitalization and evolved into multiple organ dysfunction before the transfer.

Conclusion: Surgical treatment is also an effective treatment approach for this disease, but it is necessary to correctly understand the surgical indications. The mechanism of postoperative embolism event still needs further study.


Severe ultrasound, Infective endocarditis.