{
  "abstract": "Patient: Male, 50-year-old\n\nFinal Diagnosis: Acute cerebral infarction (right temporal-parietal lobe) with secondary right frontal lobe hemorrhage • infective endocarditis • sepsis with MODS\n\nSymptoms: Disturbance of consciousness • fever\n\nClinical Procedure: —\n\nSpecialty: Cardiology • Infectious Diseases • Neurology\n\nObjective: Challenging differential diagnosis\n\nBackground: Infective endocarditis (IE) typically presents with fever, a heart murmur, or constitutional symptoms, making diagnosis challenging when neurological manifestations predominate. We report an atypical case of IE in which disturbance of consciousness was the initial manifestation.\n\nCase Report: A man in his 50s was admitted to our hospital with isolated disturbance of consciousness and no history of fever; a temperature of 38 °C was recorded on admission. Investigations confirmed an extensive acute right hemispheric watershed (border-zone) infarction involving the right temporoparietal lobe, without evidence of hemorrhagic transformation or intracranial hemorrhage. Subsequent workup identified Staphylococcus aureus bacteremia, mitral valve vegetation, and multiple organ dysfunction syndrome. The absence of classic IE risk factors contributed to a delayed diagnosis. Guideline-concordant clinical management was implemented. Long-term outcome data were unavailable because of patient transfer; only in-hospital mortality (after transfer) was confirmed. We discuss the application of the 2023 Duke criteria to this case and examine factors contributing to the delayed diagnosis of IE. Disturbance of consciousness as the predominant initial manifestation of S. aureus IE is rare and frequently results in diagnostic delay. This case underscores the importance of maintaining a high index of suspicion for IE in patients with sepsis complicated by acute cerebral infarction, particularly among critical care and neurology clinicians.\n\nConclusions: This case highlights isolated disturbance of consciousness as an atypical initial presentation of IE. Although IE is frequently complicated by acute cerebral infarction, clinicians may not routinely consider IE in the differential diagnosis of patients presenting with disturbed consciousness.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong, PR China",
    "Department of Cardiovascular, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong, PR China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Weixiong Zhong"
    },
    {
      "affs": [
        0
      ],
      "name": "Shanshan Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Jiang"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhixu Tan"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e3n90rh6dgabe.bib",
  "cited_by": 0,
  "doi": "10.12659/ajcr.953169",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13723147/",
  "id": "e3n90rh6dgabe",
  "issns": [
    "1941-5923"
  ],
  "landing_url": "https://doi.org/10.12659/ajcr.953169",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Articles"
    ],
    [
      "openalex",
      "2713|Infective Endocarditis Diagnosis and Management"
    ]
  ],
  "openalex": "W7222958284",
  "pdf_url": "https://amjcaserep.com/download/inPress/idArt/953169",
  "pmcid": "PMC13723147",
  "pmid": "42934949",
  "published": "2026-10-27",
  "publisher": "International Scientific Information, Inc.",
  "ris": "https://research.draconitic.com/paper/e3n90rh6dgabe.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:21:48Z",
      "native_id": "PMC13723147",
      "source": "pmc",
      "url": "https://doi.org/10.12659/ajcr.953169"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Infective Endocarditis Diagnosis and Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Isolated Disturbance of Consciousness as Initial Presentation of Staphylococcus aureus Endocarditis: A Case Report With Brief Literature Review",
  "title_text": "Isolated Disturbance of Consciousness as Initial Presentation of Staphylococcus aureus Endocarditis: A Case Report With Brief Literature Review",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:48Z",
  "url": "https://research.draconitic.com/paper/e3n90rh6dgabe",
  "venue": "The American Journal of Case Reports",
  "versions": []
}