Infective endocarditis related to acute cholecystitis.

A 30-year-old woman with a homologous dura-mater valve prosthesis developed infective endocarditis related to acute purulent cholecystitis occurring in chronic cholelithiasis. During anti-bacterial treatment refractory heart failure ensued which compelled replacement of the infected prosthesis. She died in the post-operative period. Autopsy revealed endocarditis on the implanted bioprosthesis, purulent cholecystitis and a gallbladder stone. It is warningly concluded that the surgical treatment of endocarditis was unsuccessful because of persistence of purulent cholecystitis that led to reinfection of the inserted prosthesis.