Hemolytic Anemia in Native Valve Infective Endocarditis-A Case Report and Literature Review-

11 References
  • HUANG Hsuan-Li
    Second Section of Cardiology and Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • LIN Fun-Chung
    Second Section of Cardiology and Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • HUNG Kuo-Chun
    Second Section of Cardiology and Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • WANG Po-Nan
    Section of Hematology, Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • WU Delon
    Second Section of Cardiology and Department of Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine

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Abstract

Hemolytic anemia is a rare manifestation of infective endocarditis. A 19-year-old man with a small ventricular septal defect developed right-sided infective endocarditis with huge vegetations involving the tricuspid valve, the ventricular septal defect, and the pulmonary valve. Intravascular hemolysis was suggested by the presence of numerous fragmented erythrocytes, giant platelets and polychromasia of the red blood cells. The direct Coombs test was positive, and there were spherocytes and splenomegaly, findings that suggested an immune-mediated mechanism also played a role in the hemolysis. The hematological picture persisted despite antibiotic therapy and recovered only after surgical removal or the vegetations, tricuspid and pulmonary valvectomy, and patch closure of the ventricular septal defect.

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