Stroke, Fever, and Clot Microbiology Analysis: A Case Report.

Infective endocarditis (IE) is a rare but serious life-threatening disease, often presenting with highly variable clinical symptoms. Risk factors for this condition include valvular heart disease, age, medical procedures, dental procedures, and intravenous drug use. Patients with IE may exhibit valve dysfunction, heart failure, or neurological complications such as stroke, the latter being caused by an embolus originating from valvular vegetations that occlude more distal vessels in the cerebral circulation. Diagnosis is based on the modified Duke criteria. We report a case of a 20-year-old male patient who presented to the emergency department with the acute onset of aphasia, right-sided hemiparesis, and fever. Neurological examination revealed a National Institute of Health Stroke Scale score of 10, and computed tomography (CT) angiography confirmed a left middle cerebral artery occlusion. Since endocarditis was not known at the time of stroke diagnosis, the patient underwent thrombolysis. He then underwent thrombectomy with successful recanalization, and the retrieved thrombus was sent for microbiological analysis. Laboratory findings showed leukocytosis, elevated erythrocyte sedimentation rate, and elevated C-reactive protein, and both blood and thrombus cultures were positive for