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Published in: BMC Neurology 1/2017

Open Access 01-12-2017 | Case report

Stroke caused by an inflammatory thrombus: a case report

Authors: Kai Shan, Wei Guo

Published in: BMC Neurology | Issue 1/2017

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Abstract

Background

Stroke is the leading cause of mortality and disability worldwide. Several definite risk factors have been identified for stroke, although infectious factors might also contribute to stroke episodes through increased susceptibility or direct induction.

Case presentation

A 46-year-old Chinese male initially presented with fever, headache, and impaired memory and developed disturbance of consciousness after admission. A clinical diagnosis of Staphylococcus aureus sepsis, massive cerebral infarction and haemorrhagic transformation (left internal carotid arterial system, inflammatory thrombus) were made based on brain radiography, blood culture and postoperative pathological examinations. These symptoms improved following antibiotic therapy with vancomycin and conventional treatments for stroke.

Conclusion

For stroke patients without traditional cerebrovascular risk factors but with signs of infection, infectious causes should be considered.
Literature
1.
go back to reference Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–223.CrossRefPubMed Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, Michaud C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197–223.CrossRefPubMed
2.
go back to reference O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case–control study. Lancet. 2016;388:761–75.CrossRefPubMed O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case–control study. Lancet. 2016;388:761–75.CrossRefPubMed
3.
go back to reference Fugate JE, Lyons JL, Thakur KT, Smith BR, Hedley-whyte ET, Mateen FJ. Infectious causes of stroke. Lancet Infect Dis. 2014;14:869–80.CrossRefPubMed Fugate JE, Lyons JL, Thakur KT, Smith BR, Hedley-whyte ET, Mateen FJ. Infectious causes of stroke. Lancet Infect Dis. 2014;14:869–80.CrossRefPubMed
4.
go back to reference Grau AJ, Urbanek C, Palm F. Common infections and the risk of stroke. Nat Rev Neurol. 2010;6:681–94.CrossRefPubMed Grau AJ, Urbanek C, Palm F. Common infections and the risk of stroke. Nat Rev Neurol. 2010;6:681–94.CrossRefPubMed
5.
go back to reference Grau AJ, Buggle F, Heindl S, Steichen-Wiehn C, Banerjee T, Maiwald M, et al. Recent infection as a risk factor for cerebrovascular ischemia. Stroke. 1995;26:373–9.CrossRefPubMed Grau AJ, Buggle F, Heindl S, Steichen-Wiehn C, Banerjee T, Maiwald M, et al. Recent infection as a risk factor for cerebrovascular ischemia. Stroke. 1995;26:373–9.CrossRefPubMed
6.
go back to reference Bova IY, Bornstein NM, Korczyn AD. Acute infection as a risk factor for ischemic stroke. Stroke. 1996;27:2204–6.CrossRefPubMed Bova IY, Bornstein NM, Korczyn AD. Acute infection as a risk factor for ischemic stroke. Stroke. 1996;27:2204–6.CrossRefPubMed
7.
go back to reference Syrjänen J, Valtonen V, Livanainen M, Kaste M, Huttunen JK. Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. BMJ (Clin Res Ed). 1988;296:1156–60.CrossRef Syrjänen J, Valtonen V, Livanainen M, Kaste M, Huttunen JK. Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. BMJ (Clin Res Ed). 1988;296:1156–60.CrossRef
8.
go back to reference Clayton TC, Thompson M, Meade TW. Recent respiratory infection and risk of cardiovascular disease: case–control study through a general practice database. Eur Heart J. 2008;29:96–103.CrossRefPubMed Clayton TC, Thompson M, Meade TW. Recent respiratory infection and risk of cardiovascular disease: case–control study through a general practice database. Eur Heart J. 2008;29:96–103.CrossRefPubMed
9.
go back to reference Nencini P, Sarti C, Innocenti R, Pracucci G, Inzitari D. Acute inflammatory events and ischemic stroke subtypes. Cerebrovasc Dis. 2003;15:215–21.CrossRefPubMed Nencini P, Sarti C, Innocenti R, Pracucci G, Inzitari D. Acute inflammatory events and ischemic stroke subtypes. Cerebrovasc Dis. 2003;15:215–21.CrossRefPubMed
10.
go back to reference Paganini-Hill A, Lozano E, Fischberg G, Barreto MP, Rajamani K, Ameriso SF, et al. Infection and risk of ischemic stroke: differences among stroke subtypes. Stroke. 2003;34:452–7.CrossRefPubMed Paganini-Hill A, Lozano E, Fischberg G, Barreto MP, Rajamani K, Ameriso SF, et al. Infection and risk of ischemic stroke: differences among stroke subtypes. Stroke. 2003;34:452–7.CrossRefPubMed
11.
go back to reference Miller E, Elkind MS. Infection and Stroke: an Update on Recent Progress. Curr Neurol Neurosci Rep. 2016;16:1–10.CrossRef Miller E, Elkind MS. Infection and Stroke: an Update on Recent Progress. Curr Neurol Neurosci Rep. 2016;16:1–10.CrossRef
12.
go back to reference Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler Jr VG. Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management. Clin Microbiol Rev. 2015;28:603–61.CrossRefPubMedPubMedCentral Tong SY, Davis JS, Eichenberger E, Holland TL, Fowler Jr VG. Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management. Clin Microbiol Rev. 2015;28:603–61.CrossRefPubMedPubMedCentral
13.
go back to reference Mejer N, Gotland N, Uhre ML, Westh H, Schonheyder HC, Petersen A, et al. Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study. J Infect. 2015;71:167–78.CrossRefPubMed Mejer N, Gotland N, Uhre ML, Westh H, Schonheyder HC, Petersen A, et al. Increased risk of arterial thromboembolic events after Staphylococcus aureus bacteremia: A matched cohort study. J Infect. 2015;71:167–78.CrossRefPubMed
14.
go back to reference Elkind MS, Ramakrishnan P, Moon YP, Bodenalbala B, Liu K, Rundek T, et al. Infectious burden and risk of stroke: the northern Manhattan study. Arch Neurol. 2010;67:33–8.CrossRefPubMed Elkind MS, Ramakrishnan P, Moon YP, Bodenalbala B, Liu K, Rundek T, et al. Infectious burden and risk of stroke: the northern Manhattan study. Arch Neurol. 2010;67:33–8.CrossRefPubMed
15.
go back to reference Epstein SE, Zhou YF, Zhu J. Infection and atherosclerosis: emerging mechanistic paradigms. Circulation. 1999;100:e20–8.CrossRefPubMed Epstein SE, Zhou YF, Zhu J. Infection and atherosclerosis: emerging mechanistic paradigms. Circulation. 1999;100:e20–8.CrossRefPubMed
16.
go back to reference Lindsberg PJ, Grau AJ. Inflammation and infections as risk factors for ischemic stroke. Stroke. 2003;34:2518–32.CrossRefPubMed Lindsberg PJ, Grau AJ. Inflammation and infections as risk factors for ischemic stroke. Stroke. 2003;34:2518–32.CrossRefPubMed
18.
go back to reference DA E, Lowe GD, Thompson S, Collins R, Danesh J, Nissinen A, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375:132–40.CrossRef DA E, Lowe GD, Thompson S, Collins R, Danesh J, Nissinen A, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375:132–40.CrossRef
19.
go back to reference Dickerman SA, Abrutyn E, Barsic B, Bouza E, Cecchi E, Moreno A, et al. The relationship between the initiation of antimicrobial therapy and the incidence of stroke in infective endocarditis: an analysis from the ICE Prospective Cohort Study (ICE-PCS). Am Heart J. 2007;154:1086–94.CrossRefPubMed Dickerman SA, Abrutyn E, Barsic B, Bouza E, Cecchi E, Moreno A, et al. The relationship between the initiation of antimicrobial therapy and the incidence of stroke in infective endocarditis: an analysis from the ICE Prospective Cohort Study (ICE-PCS). Am Heart J. 2007;154:1086–94.CrossRefPubMed
20.
go back to reference Duval X. lung B, Klein I, Brochet E, Thabut G, Arnoult F, et al. Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: A prospective study. Ann Intern Med. 2010;152:497–504.CrossRefPubMed Duval X. lung B, Klein I, Brochet E, Thabut G, Arnoult F, et al. Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: A prospective study. Ann Intern Med. 2010;152:497–504.CrossRefPubMed
21.
go back to reference Chow FC, Marra CM, Cho TA. Cerebrovascular disease in central nervous system infections. Semin Neurol. 2011;31:286–306.CrossRefPubMed Chow FC, Marra CM, Cho TA. Cerebrovascular disease in central nervous system infections. Semin Neurol. 2011;31:286–306.CrossRefPubMed
Metadata
Title
Stroke caused by an inflammatory thrombus: a case report
Authors
Kai Shan
Wei Guo
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2017
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-017-0816-3

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