22/12/2025
*Remembering Dr. Joseph Lister*
Sharing a tricky case which will make us remember the “Aseptic precautions” by Lister
Recently a patient came with right sided stroke .
He also had fever since few months .
ECHO showed large vegetation on aortic valve.
The blood cultures didn’t show any growth.
Pt was in sepsis and with very high CRP .
With high risk , took for surgical valve replacement.
*Intra op*:
Massive vegetation with destruction of aortic annulus leading to *root abscess* .
Managed to repair aortic annulus and replace valve.
By God’s grace pt did well and went home on day 10.
The culture of tissue grew *atypical mycobacteria*
Atypical mycobacterial endocarditis is very rare.
*So the villain of the story*
Microbiologist thinks the infection was probably secondary to angiography done 4 months back.
The angiography done was at a center where the reuse / cidex sterilisation was common.
*Moral of the story:*
Do not compromise on sterility in OT / Cathlab and even while handling patients.
