Chicago dad lucky to be alive after cavity causing bacteria leads to a dangerous condition

CHICAGO - In July 2021, Jay Keller wasn’t feeling like himself. The Chicago-based architect, husband and father had fatigue and cold-like symptoms.

“I thought maybe I had Lyme disease, COVID-19 or walking pneumonia; I just wasn’t sure,” said 48-year-old Keller.

By September, he developed horrible headaches, and was admitted to Northwestern Memorial Hospital for testing. Blood work showed Keller had endocarditis (an infected heart valve) from Streptococcus mutans (oral bacteria) that can cause cavities.

“We’re all exposed to little bits of bacteria from the mouth, but Jay’s stuck to his valve because he had a congenital heart abnormality – he was born with two aortic valve leaflets instead of three, called a bicuspid aortic valve. It’s associated with a higher risk of cardiovascular complications, including endocarditis,” said Karen Krueger, MD, infectious diseases specialist at Northwestern Medicine.

“Because of the two-leaflet valve, the flow across that valve was not normal, and it lent to the valve getting infected more easily. Jay developed an infection of that valve, which then caused a stroke,” said Duc Thinh Pham, MD, cardiac surgeon at Northwestern Medicine.

Each time Keller’s heart would beat, it would push blood through the infected valve and flick pieces into his brain, causing an infected mycotic brain aneurysm, which is a very dangerous condition. Due to the important blood vessels involved, Babak Jahromi, MD, PhD, neurosurgeon at Northwestern Medicine, had to open Keller’s skull, cut the aneurysm out, and sew the affected brain blood vessels to other unaffected brain blood vessel segments. It was the first time Dr. Jahromi performed a double bypass for a mycotic aneurysm. The rare, 8-hour procedure preserved Keller’s important blood vessels.

“It’s basically redoing the plumbing of the brain by cutting out the part that’s bulging out and getting the remaining tubes to connect to each other,” said Dr. Jahromi. “Having a fusiform brain aneurysm is very uncommon and having that be related to a heart infection is even more uncommon. Jay came to the right place because Northwestern Medicine had the right team to deal with potential simultaneous disasters.”

Just a few days following brain surgery, Keller was already up and walking the hospital hallways. He logged seven miles in one day and couldn’t believe how much better he felt.

Two months later, Keller was back in the operating room with Dr. Pham who fixed the infected heart valve on April 21, 2022. Surgeons also found a small hole in Keller’s heart that they were able to fix. 

Keller recently finished cardiac rehabilitation and he’s ready to get back to running, biking, swimming, and spending quality time this Father’s Day with his wife, Grace, and their 7-year-old son, Hudson.

 “Obviously, it takes on a little more appreciation when you go through something like this,” said Keller. “You go back and re-visit your priorities.”