Article ID: 11009
The patient was a 52-year-old man who had an acute cerebral infarction due to occlusion of the basilar artery (BA). Intravenous rt-PA and mechanical thrombectomy (MT) were performed, which resulted in recanalization of the BA. At the time of onset, there were no symptoms or findings suggestive of infection. However, shaking chills appeared during the MT procedure. We suspected bacteremia, and cultured the embolus and blood obtained during the MT, as well as performed echocardiography. We diagnosed a large vessel occlusion (LVO) caused by infective endocarditis (IE) due to Streptococcus sanguinis (S. sanguinis). S. sanguinis is a commensal organism important in promoting oral health but may cause subacute IE. The existence of subacute IE, its symptoms, and its risk of LVO may not be well recognized. Therefore, the possibility of subacute IE due to S. sanguinis should be given attention in acute stroke practice.
