Alfredo  Pérez-Cuadra,Jorge  Villalpando-Hernández,Mario Zuñiga,Renata  Díaz-Pérez,Ricardo A.  Valdovinos-Nuñez,
Personality Disorder as the Initial Presentation of a Complicated Endocarditis: Diagnostic Challenges in the CARDIO-PSYCHIATRY
Cardiovascular Disorder and Medicine
2020

http://dx.doi.org/10.31487/j.CDM.2020.01.02
https://www.sciencerepository.org/personality-disorder-as-the-initial-presentation-of-a-complicated-endocarditis_CDM-2020-1-102 
Abstract: Background: Bacterial endocarditis is a rare infectious entity with a very heterogeneous clinical spectrum;
neurological manifestations are the most frequent and serious extracardiac complications of infective
endocarditis. However, little is known about the psychiatric manifestations and / or sequels due to septic
embolism of the infective endocarditis.
Case Report: 50-year-old male, history of arterial hypertension and nephrolithiasis with recurrent urinary
tract infections. He began his condition with behavioral changes characterized by marked impulsivity and
instability in his interpersonal relationships, adding repetitive events of fever and nephrolithiasis requiring
urological interventions and antibiotic therapy. Upon admission assessed by psychiatry because of his
impulsive behavior and emotional changes with the presumptive diagnosis of borderline personality
disorder.
Conclusion: In the following work we describe the first case found in the literature of a psychiatric
manifestation in a male patient as the initial complication of a subacute bacterial endocarditis, his diagnostic
approach, clinical picture and therapeutic outcome. The early recognition of the clinical picture and the
diagnostic approach allowed to establish effective antibiotic treatment; to recognize that bacterial
endocarditis might present in a multifaceted way allows to suspect this disease and give treatment
opportunely to reduce its burden and mortality.
Keywords: Infective endocarditis, Personality disorders, Stroke, Neurological complications