Patient care with infective endocarditis during active COVID-19 infection

Introduction: Infectious endocarditis (IE) is a potentially life-threatening condition that requires urgent diagnosis and treatment1 . Heart valve associated with COVID infection presents challenge, not only for physicians but nurses as well. Considering the situation implementation of new epidemiological measures, challenging nursing care in changed difficult working conditions presented an important factor treatment patient. In this paper we will present case 36-year-old patient who was hospitalized December 2020 University Hospital Dubrava infectious complicated by COVID-19. Case report: Patient initially October at Diseases pneumococcal pneumonia meningitis. Mechanical ventilation begins due to development respiratory insufficiency. Vancomycin antibiotic therapy consequently results acute renal injury. Renal function recovers after short period hemodialysis. During stay, cardiorespiratory arrest developed resuscitation successfully performed. Transthoracic echocardiography finds perivalvular abscess aortic without visible vegetation. After month hospitalization, there further deterioration clinical condition. Testing coronavirus (SARS-CoV-2) performed positive finding confirmed, bilateral COVID-19 failure requiring oxygen mechanical ventilation. Due need diagnosis, transesophageal ultrasound heart, which could be trained staff, measures prevent spread virus, transferred became central hospital Republic Croatia. Transesophageal ultrasound, compliance all safety found root pseudoaneurysm large mobile vegetation on massive regurgitation, confirmed endocarditis. Massive pleural effusion signs distress syndrome (ARDS) verified. Emergency cardiac surgery indicated A biological implanted, repaired remaining defect closed pericardial patch. Postoperative recovery proceeded complications. Control records normal hemodynamic parameters over valve. With adequate intensive physical therapy, recovered discharged home twelfth postoperative day. Conclusion: led prolongation infective Despite taken, accelerated progression IE symptoms leading arrest. The patient’s required medical staff (physicians, nurses, perfusionists, technicians) adherence pre-planned hospitals meet demanding conditions. (English) [ABSTRACT FROM AUTHOR] Uvod: Infektivni endokarditis je potencijalno životno ugrožavajuce stanje koje zahtijeva žurnu dijagnozu i pocetak lijecenja1 Endokarditis srcanog zaliska udružen s infekcijom predstavlja izazov, ne samo za lijecnike, vec medicinske sestre. S obzirom na novonastalu situaciju provođenje epidemioloskih mjera, zahtjevna sestrinska skrb u promijenjenim teskim uvjetima rada predstavljala bitan faktor lijecenju bolesnika. Prikazujemo slucaj 36-godisnjeg bolesnika koji prosincu 2020. godine lijecen KB zbog infektivnog endokarditisa kompliciranog infekcijom. Prikaz slucaja: Bolesnik listopadu inicijalno hospitaliziran Klinici infektivne bolesti pneumokokne pneumonije meningitisa. Zbog razvoja respiratorne insuficijencije mehanicki ventiliran. Posljedicno primjeni antibiotske terapije vankomicinom, dolazi do akutne bubrežne ozljede. Bubrežna funkcija se oporavlja nakon kratkog perioda hemodijalize. Tijekom boravka kardiorespiratornog aresta te uspjesno provedena reanimacija. Transtorakalnom ehokardiografijom registrira perivalvularni apsces aortne valvule bez vidljivih vegetacija. Nakon mjesec dana hospitalizacije daljnjeg pogorsanja klinickog stanja. Ucinjeno testiranje korona virus potvrđen pozitivan nalaz, uz razvoj bilateralne respiratornom insuficijencijom koja zahtijevala terapiju kisikom daljnju mehanicku ventilaciju. potrebe daljnjom dijagnostikom, transezofagijskom ehokardiografijom, mogao izvesti educirano osoblje mjera sprjecavanje sirenja virusa, bolesnik premjesten Klinicku bolnicu postala sredisnja bolnica Republiku Hrvatsku. Ucinjenim transezofagijskim ultrazvukom, pridržavanje svih propisanih sigurnosti, nađe korijena aorte sa pseudoaneurizmom veliku mobilnu vegetaciju aortnoj valvuli masivna aortna regurgitacija potvrđena dijagnoza endokarditisa. Verificiran masivni bilateralni pleuralni izljev znakove akutnog respiracijskog distres sindroma (ARDS). Kod bila indicirana hitna operacija srca lijecenja valvule. Uspjesno implantirana bioloska valvula, saniran ostatni defekt zatvoren perikardijalnom zakrpom. Postoperativni oporavak protekao komplikacija. Kontrolnom evidentiraju uredni hemodinamski parametri nad aortnom valvulom. Uz adekvatnu sestrinsku intenzivnu fizikalnu oporavio otpusten kuci dvanaestog postoperativnog dana. Zakljucak: Pozitivan nalaz doveo prolongacije postavljanja dijagnoze Unatoc svim primijenjenim mjerama infekcija ubrzala progresiju simptoma dovodeci urusaja. Bolesnikovo zahtijevalo hitnu kardiokirursku operaciju mogla biti izvedena jedino medicinsko (lijecnici, sestre, perfuzionisti, tehnicari) unaprijed predviđenim bolnicama su mogle ispuniti zahtjevne uvjete. (Croatian) Copyright Cardiologia Croatica property Croatian Cardiac Society its content may copied or emailed multiple sites posted listserv copyright holder's express written permission. However, users print, download, email articles individual use. This abstract abridged. No warranty given about accuracy copy. Users should refer original published version material full abstract. (Copyright applies Abstracts.)