Fatal cerebroembolism from nonbacterial thrombotic endocarditis in a trauma patient: Case report and review

Sanjeev Sharma, John C. Mayberry, Thomas G. Deloughery, Richard J. Mullins

    Research output: Contribution to journalArticle

    6 Scopus citations

    Abstract

    Nonbacterial thrombotic endocarditis (NBTE) is a rare condition that may result in an unexpected and usually fatal cerebroembolism. It occurs in a variety of clinical situations, including malignancy, immune disorders, and sepsis, but it has rarely been reported after trauma. The formation of NBTE appears to require a hypercoagulable state and changes in valvular morphology, e.g., during a hyperdynamic state. Patients with disseminated intravascular coagulation have a 21% incidence of NBTE. Although NBTE is usually found at autopsy, premorbid detection by echocardiography is currently possible and feasible. Untreated patients have a high incidence of embolic events, but anticoagulation with heparin may be lifesaving. A lethal case of NBTE in a severely injured patient is reported here with the purpose of increasing awareness among medical personnel caring for trauma patients. Recommendations have been made for surveillance echocardiography in high-risk patients, e.g., critically ill patients with sepsis or disseminated intravascular coagulation.

    Original languageEnglish (US)
    Pages (from-to)83-85
    Number of pages3
    JournalMilitary medicine
    Volume165
    Issue number1
    DOIs
    StatePublished - Jan 2000

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

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