Neurologic Complications, Presentation, and Diagnosis

Neurologic complication is common in infective endocarditis (IE), and it can be the initial reason for the patient to seek medical care. They indicate severe systemic disease, and is associated with worse patient outcomes. Patient presentation can range from nonspecific encephalopathy to an acute focal neurological deficit from septic emboli from valve vegetation causing ischemic stroke or hemorrhage. In addition, hematogenous spread of infection can also result in CNS abscesses and meningitis. Timely assessment with thorough history, examination, and appropriate imaging to assess for neurological involvement are crucial for management.