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

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

    Research output: Contribution to journalArticle

    5 Citations (Scopus)

    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
    StatePublished - Jan 2000

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    Endocarditis
    Wounds and Injuries
    Disseminated Intravascular Coagulation
    Echocardiography
    Sepsis
    Immune System Diseases
    Incidence
    Critical Illness
    Heparin
    Autopsy
    Neoplasms

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health

    Cite this

    Fatal cerebroembolism from nonbacterial thrombotic endocarditis in a trauma patient : Case report and review. / Sharma, Sanjeev; Mayberry, John C.; Deloughery, Thomas; Mullins, Richard.

    In: Military Medicine, Vol. 165, No. 1, 01.2000, p. 83-85.

    Research output: Contribution to journalArticle

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