A case of post-esophagectomy infective endocarditis with sepsis and dic

Abstract

We report the case of a patient with nutritional deficiency who developed infective endocarditis after esophagogastrectomy. A 55-year-old man who had undergone esophagectomy at the age of 54, was subsequently administered oral anticancer drug treatment ; however he abandoned the treatment due to adverse effects (diarrhea, dysgeusia) 2 months later. He was admitted with chronic undernutrition and persistent dysgeusia after 6 months. He was administered empirical antimicrobial therapy because of increasing high fever 1 month after admission. He was less responsive to appropriate anti-MRSA therapy for beating MRSA bacteremia and infective endocarditis. Then, septic shock and DIC occurred with progressive infective endocarditis. In spite of intensive care, he died due to multiple brain hemorrhage. Antimicrobial therapy was unsuccessful in curing severe infective endocarditis due to MRSA in a post-surgical patient with esophageal cancer. A fast and more accurate diagnosis method as well as treatment are required for treating infective endocarditis.