Encephalopathy with staphylococcal endocarditis: Multiple neuropathological findings

Background: Infective endocarditis is associated with serious neurological sequelae. Objective: Here, we report a patient with Staphylococcus aureus e ndocarditis, secondary to congenital heart disease, with subacute onset of multiple neurological complications. Results: Despite prompt antibiotic tre atment with rapid sterilization of blood cultures, the patient died with br ain herniation within 96 hours of admission. Neuropathological examination showed intraparenchymal hemorrhages, mycotic aneurysms, micro-abscesses and septic arteritis with accompanying infarction. Immunocytochemical. studies revealed enhanced CD45 and GFAP immunoreactivity, together with adenosine Al receptor detection on macrophages and microglia. Conclusions: Infective endocarditis is associated with multiple neuropathological lesions, which m ay contribute to its poor clinical outcome and activation of cells of monoc yte-microglial lineage throughout the brain.