[Difficulties in the differential diagnosis of splenic infarction and splenic abscess in a patient with active infective endocarditis -- case report and current review].

Systemic embolization is the most common extracardiac complication of active infective endocarditis (IE). The assessment of individual patient risk for embolic events in active IE is very difficult. Staphylococcal or fungal endocarditis, infections caused by HACEK and Abiotrophia spp. microorganisms, anterior mitral leaflet vegetations and vegetations with size >10 mm in TTE are associated with higher rate of arterial embolization. In this report we present a 66-year-old patient with active enterococcal aortic native valve endocarditis, with a history of gastric ulcers and with acute abdominal pain due to splenic infarction. We conclude that abdominal pain, particularly in the left-upper-quadrant, may be a sign of splenic infarction. Confirmation of this complication by ultrasonography provides important information about increased risk of future systemic embolic events.