Valve Destruction and Fatal Acute Aortic Regurgitation in Staphylococcal Infective Endocarditis: A Case Report

Abstract

Background: Infective endocarditis remains a life-threatening disease with significant morbidity and mortality. Acute aortic regurgitation is among the most severe complications of infective endocarditis and results from rapid destruction of the aortic valve apparatus. This condition frequently leads to acute heart failure and requires urgent surgical intervention. Case presentation: We report the case of a 58-year-old woman with no prior history of cardiovascular disease who was admitted for native aortic valve infective endocarditis caused by Staphylococcus haemolyticus. Transthoracic echocardiography revealed severe acute aortic regurgitation with preserved left ventricular systolic function. Transesophageal echocardiography demonstrated extensive destruction of the aortic cusps with loss of leaflet coaptation and massive regurgitation. Blood cultures confirmed Staphylococcus haemolyticus infection. Despite prompt initiation of targeted intravenous antibiotic therapy and intensive medical management, the patient developed progressive renal failure and acute decompensated heart failure. Urgent surgical aortic valve replacement was indicated; however, the patient experienced rapid hemodynamic deterioration and died before surgical intervention could be performed. Conclusion: This case illustrates the fulminant course of staphylococcal infective endocarditis complicated by acute aortic regurgitation. Early recognition of severe valvular destruction and immediate referral for surgical management are essential to improve survival in this life-threatening condition.