Follow the heart: A tale of possible infective endocarditis in a patient co-infected with Methicillin-resistant Staphylococcus aureus and Severe Acute Respiratory Syndrome Coronavirus 2
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Figure 1
Electrocardiogram showing sinus rhythm, ventricular rate of 55/minute, and signs of left ventricular hypertrophy.
Figure 2
Transthoracic echocardiography in (A) parasternal long axis view showing severe mitral annular calcification and thickened mitral leaflet; (B) four-chamber view demonstrating moderate mitral valve stenosis by the pressure half-time method; and (C) five-chamber view showing severe aortic stenosis by continuous wave Doppler interrogation.
LA - left atrium; LV - left ventricle; RV - right ventricle
Figure 3
Computed tomography of the lung showing bilateral lower lobes consolidations. The arrows indicate subsegmental lower lobes consolidation with minimal pleural effusion.
Figure 4
Computed tomography of the brain showing (A) frontal intraparenchymal cerebral hemorrhage and perilesional edema in transversal view; (B) subarachnoid hemorrhage in sagittal view; and (C) frontal intraparenchymal hemorrhage in frontal view.
The arrows indicate (A) a 17 mm frontal hematoma with peri-hemorrhagic edema; (B) left parietal subarachnoid hemorrhage; and (C) frontal hematoma.
Figure 5
Repeated computed tomography of the brain showing new occipitotemporal cortical hypodensity and parenchymal swelling.
The arrows indicate a subacute ischemic lesion in the occipitotemporal cortex together with perilesional swelling.
Figure 6
Initial (A) transthoracic echocardiography in short axis view showing calcified aortic valves and repeated (B) echocardiography with suspicion of a small mass attached to the aortic cusp.The arrows indicate (A) a degenerative tricuspid aortic valve and (B) a small mass attached to the aortic valve.