FOCAL NEUROLOGIC DEFICITS IN INFECTIVE ENDOCARDITIS AND OTHER SEPTIC DISEASES

Introduction - Focal neurologic deficits in sepsis frequently result f rom parenchymal lesions due to cerebral embolism. The aim of this stud y was to characterize clinical, laboratory and radiologic patterns of those patients. Patients and methods - Medical records of 30 patients with focal neurologic symptoms during sepsis were analyzed retrospecti vely. Results - 24 patients (22 with infective endocarditis) had ische mic stroke. Cerebrospinal fluid (CSF) analyses revealed inflammation i n 11 of 12 patients. Patients who died (11/24) suffered more frequentl y from secondary intracerebral hemorrhage (p=0.0031), which was signif icantly associated with intravenous high-dose anticoagulation (p=0.005 9). Six patients had slowly progressive focal neurologic deficits with out evidence for stroke. All showed CSF inflammation and three develop ed multiple cerebral abscesses. Conclusions - There are two distinctiv e groups of patients with focal neurologic deficits during sepsis. One presents with stroke and CNS inflammation (septic embolic focal encep halitis). The other group develops slowly progressive focal neurologic deficits and sometimes multiple cerebral abscesses (septic metastatic focal encephalitis).