114 SIMULTANEOUS THROMBOSIS AND ENDOCARDITIS OF A MITRAL VALVE PROSTHESIS

Background: 23 year old male patient with Behcet’s disease and repaired VSD and aortic valve diagnosed to have infective endocarditis due to unusal organism. Case summary: 23 year old with Behcet’s disease and repaired VSD and aortic valve presented with fever and abdominal pain. CT abdomen showed wedge infarction of the kidney. TEE confirmd presence of large vegetation in the aortic valve. Blood culture grew Gemella sanguinis after sent to refrence lab. Patient was treated with ceftriaxone and responded clinically and microbiologically. 4 weeks later he developed new ischaemic insult to his right Ring finger and new infarcion in the kidney. It was attributed to hypercoagulable state caused by active Behcet’s disease and patient started on anticoagulation. Few days later patient developed intracerebral bleeding which led to his demise. Conclusion: This is only the 3rd case of infective endocarditis caused by Gemella sanguinis. It caused a big vegetation and probably was complicated with cerebral mycotic aneurysm. Mouth ulcers caused by Behcet’s disease is the most likely port of entry for the bacteremia and endocarditis caused by Gemella sanguinis in our patient.