Infective endocarditis (IE) is a severe condition that may initially present with neurological complications.Early recognition and timely management are essential to improve clinical outcomes.We report the case of a patient with native-valve IE complicated by an ischemic cerebrovascular event, integrating diagnostic imaging and standardized clinical criteria.A 58-year-old man with a history of prostate adenocarcinoma presented with acute neurological deficits.Magnetic resonance imaging showed a right medullary infarction, and echocardiography demonstrated severe aortic regurgitation with valvular vegetations meeting modified Duke criteria.Targeted beta-lactam therapy was initiated with multidisciplinary monitoring.Due to the ischemic neurological event, surgical intervention was deferred to reduce the risk of intracranial hemorrhage.Aortic valve replacement was performed during the fifth week, with favorable postoperative recovery.Infective endocarditis complicated by ischemic stroke represents a therapeutic challenge, particularly regarding the timing of surgery.Coordinated management involving cardiology, neurology, infectious diseases, and cardiovascular surgery is essential to optimize outcomes in patients requiring delayed surgical intervention.
Juan-Guardela et al. (2026) studied this question.