Nonbacterial thrombotic endocarditis presenting as aortic stenosis with suspected infective endocarditis: clinicopathological correlation.

Abstract

Endocarditis has been traditionally classified as infective and non-bacterial thrombotic endocarditis (NBTE). NBTE has been associated with connective tissue diseases, chronic inflammatory processes and malignancy. During the pre-echocardiography era, the diagnosis of NBTE was most commonly determined at postmortem examination. A 63-year-old female patient with transient cerebral ischemic attacks and weight loss, who subsequently presented with aortic stenosis, is reported. She was treated for infective endocarditis, but developed a clinical picture of sepsis with disseminated intravascular coagulation. Despite aortic valve replacement, she died early postoperatively. Autopsy found valvular NBTE, multiple vascular thromboses and associated metastatic adenocarcinoma of unknown primary site. NBTE associated with malignancy April clinically mimic sepsis and infective endocarditis.