Mitral valve endocarditis due to Staphylococcus capitis in a very old woman Un caso di endocardite della valvola mitrale da Staphylococcus capitis in donna anziana

Infective endocarditis is most frequent in over 65 years old subjects, often due to Streptococci and Staphylococci . Among uncommon pathogens, only twelve cases of natural valve endocarditis by Staphylococcus capitis with mean age of seventy years have been described (the younger patient is 29 and the oldest 80 years old) 2 . Among these cases, six are mitralic, four aortic and one both . The infection of mitral valve seems to increase the risk of cerebrovascular complications such as stroke described in 20-40% cases . In particular the migration of a fragment or the whole vegetation in the cerebral circulation are the most important causes of neurological events . Even if the neurological complications by infective endocarditis are common , only one patient with Staphylococcus capitis infection and neurological complications has been described, which died . Among risk factors for neurological events, one of the most important is the size of vegetation. In fact, a vegetation > 10 mm in diameter predisposes for neurological embolization, in particular in the middle cerebral artery territory. Neurological complications are linked to disability and increase death rate . Finally, among Staphylococcus capitis endocarditis, death is occasionally reported: in fact, only two patients died, one for neurological complications 6 and one for multi-organ failure . casE rEport caso clinico