engleski

Acute cerebrovascular incident caused by septic emboli

Septic emboli (SE) is a rare disorder associated with infective endocarditis, urinary tract infections, bone infections, femoral thrombophlebitis and sinusitis. We present a case of 53-year-old patient with multiple systemic embolism and cerebral infarction resulting from aortal thrombus after a surgical treatment of right fi bular maleolar fracture with osteosinthetic material placement. After a surgery the patient became antisocial, with decrease in appetite and substantial weight loss. Computerized tomography (CT scan) showed several small hypodense zones in supratentorial and periventricular region of the brain as well as bilateral pleural eff usion, large infarcts of the spleen and right kidney, smaller infarcts of the lower pole of the right kidney, discontinuity of the wall of the thoraco- abdominal aorta and the thrombus present in the distal part of the abdominal aorta. Th e fi ndings primarily indicate septic emboli. X-ray of right ankle showed still present postoperative fracture gap of right fi bular maleola with reduced bone mineralization but no signs of bone destruction. Th e control MSCT of the abdomen showed large spleen abscess size 10x6 cm. Due to edema of the right ankle, the ultrasound is preformed and the thick content in the joint is found so the patient was transferred to the Surgical Clinic where splenectomy with the evacuation of perisplenical abscess together with the extraction of the osteosintetic material of the right fi bular maleola was performed. If not promptly diagnosed SE can cause devastating neurological damage. In our patient early diagnosis and intensive physical therapy facilitated almost complete regression of his neurological defi cit.

Septic emboli ; cerebral infarction

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