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.