[Multivalvular infective endocarditis with Enterococcus faecalis].

Infective endocarditis (IE) is a relatively rare disease that can take part of sepsis and may be a diagnostic and therapeutic challenge. Polyvalvular location of El is rare. We present a patient of 60 years diagnosed with plurivalvular infective endocarditis by Enterococcus faecalis with septic complications, visceral, dragged, hospitalized for a psychiatric pathology, who raised the problems of diagnosis and treatment, without being able to make assessments on the entrance gate. For help in diagnosing this case proved that cardiac ultrasound studies recommended that a screening method for patients with bacteremia, but the presence of vegetation is the major criterion for diagnosis of EI. Blood cultures and echocardiography led to the diagnosis of infectious endocarditis. Also abdominal ultrasound confirmed the clinical suggestion of gravity, the septic multiviscerale release by splenic abscess image objectivity. Under vigorous antibiotic treatment and symptomatic treatment in combination evolution was to worse, death occurring after 15 days of hospitalization, toxic-septic shock being irreversible. Our case is particular by locating polyvalvular vegetation, the germ involved, the court altered the immunological and disseminator septic complications that have limited therapeutic options and made predictable fatal diagnosis.