Muhammad Yasir Adeel

Rheaume BA, et al. Yonsei Med J. 2024 Jun;65:e34. https://doi.org/10.3349/ymj.2023.0367

We report the case of a 52-year-old gentleman, admitted to the medical intensive care unit with multiple organ system dysfunction due to acute severe pancreatitis. He was found to have severe hypocalcemia, bradycardia and an electrocardiogram (EKG) showing ST-segment elevation in infero-lateral leads. The patient was treated with intravenous calcium gluconate with prompt improvement of heart rate and reversal of EKG changes. Subsequent evaluation for myocardial ischemia was negative. We believe the EKG changes mimicking acute ST-segment elevation myocardial infarction were due to severe hypocalcemia. To our knowledge this is very rare occurrence.

Brugada syndrome (BrS) is an inherited channelopathy disease, caused by genetic changes in transmembrane ion channels. It has an increased risk of sudden cardiac death (SCD) in the absence of a structural heart disease. We report a case in which the presenting electrocardiogram (EKG) exhibited a type 1 Brugada-like pattern during an adrenal crisis with transformation into a type 2 Brugada-like pattern as the crisis improved.

Infective endocarditis (IE) is a serious and life-threatening cardiac condition, most commonly caused by staphylococci, Streptococcus viridans, and enterococci. However, in special settings, IE can be caused by rare organisms. Here we present a case of IE caused by Aerococcus urinae in a 75-year-old man with a bioprosthetic aortic valve. Aerococcus urinae is a gram-positive, catalase-negative microorganism and is usually an isolate of complicated urinary tract infections in the elderly male population. Improvements in diagnostic testing including use of matrix-assisted laser desorption ionization– a time of flight mass spectrometry (MALDI-TOF MS) have played an important role in recognition of Aerococcus urinae.

Infective endocarditis (IE) is a serious and life-threatening cardiac condition, most commonly caused by staphylococci, Streptococcus viridans, and enterococci. However, in special settings, IE can be caused by rare organisms. Here we present a case of IE caused by Aerococcus urinae in a 75-year-old man with a bioprosthetic aortic valve. Aerococcus urinae is a gram-positive, catalase-negative microorganism and is usually an isolate of complicated urinary tract infections in the elderly male population. . Improvements in diagnostic testing including use of matrix-assisted laser desorption ionization– a time of flight mass spectrometry (MALDI-TOF MS) have played an important role in isolating Aerococcus.

Infective endocarditis (IE) is a serious and life threatening cardiac condition, most commonly caused by staphylococci, streptococci, enterococci and rarely by HACEK organisms (Haemophilus,Aggregatibacter,Cardiobacterium,Eikenella corrodensandKingella). Here, we present a case of IE caused byAerococcus urinaein a 75-year-old man with a bioprosthetic aortic valve. Aerococcus urinaeis a gram-positive, catalase negative microorganism, and is usually an isolate of complicated urinary tract infections in the elderly male population. It is associated with high morbidity and mortality. Awareness of this organism as a cause of IE is important, since failure to recognize the condition may lead to adverse clinical outcomes and significant complications with even fatal outcome, as in this case.

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