Infective Endocarditis Complicated by Carotid Artery Thrombosis and Infectious Intracranial Aneurysm: A Case Report

Infective endocarditis concurrently complicated by carotid artery thrombosis and rupture of an intracranial aneurysm with hemorrhage is clinically rare. Its treatment presents contradictions, as both the carotid artery thrombosis and the rupture of the intracranial aneurysm with hemorrhage need to be considered, posing challenges to clinical management. This report describes a patient who presented with hemiplegia. During the physical examination, we found that the patient had a fever of 38.5°C and a systolic murmur was auscultated in the mitral valve area. Subsequently, blood cultures and echocardiography were performed, leading to a diagnosis of infective endocarditis. A brief discussion on the neurological complications of infective endocarditis is also provided. Cranial vascular examinations revealed carotid artery thrombosis and intracranial aneurysms, and subsequent consideration was given to aneurysmal rupture with hemorrhage. After anti-infective treatment, the patient's symptoms improved. Through this case report, we emphasize that when patients present with neurological complications accompanied by fever and cardiac murmurs, infective endocarditis should be considered as a potential diagnosis.