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 journalArticlepeer-review

8 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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