Matrix Science Medica (MSM)

A 60‑year‑old, right‑handed female patient with no past medical history was found unresponsive at home by her husband. She was taken to the regional hospital. On presentation, her Glasgow Coma Scale was 10, not fully awake, temperature of 38.5°C, tachycardia, and tachypnea. Her serum glucose was over 400 mg/dl which later confirmed to be new onset diabetes mellitus. She was started on broad-spectrum antibiotics and admitted to the intensive care unit. An emergent echocardiogram obtained due to positive blood cultures for Methicillin-sensitive Staphylococcus aureus later that day. Echocardiogram showed moderate mitral valve stenosis with mean gradient of 8.8 mmHg. Mitral annulus was severely calcified. The posterior leaflet showed minimal mobile 0.8 cm × 0.9 cm vegetation consistent with acute bacterial endocarditis. She was changed to nafcillin infusion for MSSA endocarditis. Due to her neurological status, an magnetic resonance imaging (MRI) of the brain obtained, which showed small acute or early subacute infarcts scattered throughout different vascular territories affecting both cerebral and cerebellar hemispheres, the brainstem and left thalamus.