Embolism is very frequently found in patients with infective endocarditis (IE), fundamentally in cerebral arteries. An early diagnosis and possible complications seem to be related to morbidity and mortality. Echocardiography has a considerable function in early diagnosis, and, also, when we evaluate the risk of major cerebral embolism. However there is no agreement in the second aspect: for some authors echocardiography only slightly aids, but others consider it of great value in identifying high-risk patients. We describe a patient who suffers infective endocarditis by Staphylococcus aureus with significant neurological complications in its evaluation. Vegetation was disclosed by transesophageal echocardiography (TEE), whereas transthoracic echocardiography (TTE) was unable to do so. This is why we underline the role of TEE in the diagnosis and description of vegetation features (size, mobility and implantation) which seem to be linked to the risk of cerebral complications.

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