Hemorrhagic brain abscess in infective endocarditis

We report a case of infective endocarditis (IE) that presented with acute neurological deterioration due to bleeding into a brain abscess disseminated from mitral valve vegetation. The patient recovered following surgical evacuation of hemorrhage/abscess and prolonged systemic administration of antibiotics. Although IE causes various neurological complications including intracranial hemorrhage, hemorrhagic brain abscess in patients with IE is rare. Appropriate combination of diagnostic modalities including computed tomography, magnetic resonance imaging, cardiac ultrasonography, and cerebral angiography, together with careful evaluation of the clinical history, leads to accurate diagnosis and treatment of patients with IE presenting with neurological complications.