{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:30:35Z","timestamp":1772253035998,"version":"3.50.1"},"reference-count":36,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["22wm0125010h0003"],"award-info":[{"award-number":["22wm0125010h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"the International Postdoctoral Fellowship 2021, Mahidol University","award":["22wm0125010h0003"],"award-info":[{"award-number":["22wm0125010h0003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10\/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.<\/jats:p>","DOI":"10.3390\/tropicalmed8010053","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T03:02:06Z","timestamp":1673319726000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant Staphylococcus aureus Bacteremia: A Case Report from the Maldives"],"prefix":"10.3390","volume":"8","author":[{"given":"Ali","family":"Shafeeq","sequence":"first","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-6334","authenticated-orcid":false,"given":"Hisham Ahmed","family":"Imad","sequence":"additional","affiliation":[{"name":"Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok 10400, Thailand"},{"name":"Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Azhad","sequence":"additional","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Migdhaadh","family":"Shareef","sequence":"additional","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Shaneez","family":"Najmy","sequence":"additional","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Mausool","family":"Siraj","sequence":"additional","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Sunil","sequence":"additional","affiliation":[{"name":"National Cardiac Center, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rimsha","family":"Rafeeu","sequence":"additional","affiliation":[{"name":"Trauma and Emergency, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aishath Sofa","family":"Moosa","sequence":"additional","affiliation":[{"name":"Trauma and Emergency, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Shaheed","sequence":"additional","affiliation":[{"name":"Department of Medicine, Indira Gandhi Memorial Hospital, Mal\u00e9 20002, Maldives"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thundon","family":"Ngamprasertchai","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-2765","authenticated-orcid":false,"given":"Wasin","family":"Matsee","sequence":"additional","affiliation":[{"name":"Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok 10400, Thailand"},{"name":"Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyae Linn","family":"Aung","sequence":"additional","affiliation":[{"name":"Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5484-7130","authenticated-orcid":false,"given":"Wang","family":"Nguitragool","sequence":"additional","affiliation":[{"name":"Mahidol Vivax Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"},{"name":"Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3439-8331","authenticated-orcid":false,"given":"Tatsuo","family":"Shioda","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Education and Research, Department of Viral Infections, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"690","DOI":"10.3109\/00365548.2011.577801","article-title":"War and infection in the pre-antibiotic era: The Third Ottoman Army in 1915","volume":"43","author":"Erdem","year":"2011","journal-title":"Scand. 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