Introduction
Without prompt diagnosis and appropriate treatment, infective
endocarditis can lead to numerous complications and even death. Causes
of bacteremia include infections from intravascular catheters,
hemodialysis, and dental procedures; furthermore, recently there have
been reports of its connection with atopic dermatitis. Atopic dermatitis
is associated with a decreased production of antimicrobial
peptides,1,2 which are involved in skin defense
against infection, rendering the skin susceptible to infection withStaphylococcus aureus , a common microbial resident of the skin.
Additionally, bacteria can easily invade because of itchiness and
scratching.
The incidence of atopic dermatitis among patients with infective
endocarditis reportedly ranges from 1% to 7%.3,4 It
is more common in younger patients, with a mean age of 28.4 years in 8
reported patients; therefore, failure to recognize this association may
delay diagnosis.4 Among patients with infective
endocarditis and atopic dermatitis, the rate of embolism is high,
requiring close management and appropriate timing of surgery. There is a
high possibility of postoperative mediastinitis after median sternotomy;
hence, minimally invasive cardiac surgery (MICS) can be considered.
Herein, we report a patient with infective endocarditis associated with
atopic dermatitis who underwent successful MICS, with no postoperative
wound infection or pyothorax.