Bloodstream Infections and Infective Endocarditis — Viva Defence

Opening statement (SASPOP, delivered aloud)

"Mr Kelly is a 58-year-old man with early prosthetic-valve endocarditis — staphylococcal, with a paravalvular abscess — complicated by a septic embolic stroke without haemorrhagic transformation. His main problems are: active endovascular infection with uncontrolled local extension; neurological injury from embolism; the anticoagulation dilemma of a mechanical valve in the setting of a fresh septic infarct; and the near-certain need for redo valve surgery. My priorities are organism-directed intravenous therapy for a counted six weeks, urgent surgical review, brain imaging to guide anticoagulation, and a multidisciplinary decision about timing." ^{[1] [2]}