Bilateral multivalvular polymicrobial endocarditis in an intravenous drug user

Yıl 2018, Cilt: 35 Sayı: 3, 77 - 79, 31.10.2019

Özgül Uçar Elalmış Ümit Güray Mehmet İleri Deniz Şahin

Öz

A 30-year-old man with a history of
intravenous drug use presented to emergency room with fever, fatigue and
altered mental status. He was admitted to intensive care unit with the
diagnosis of sepsis, disseminated intravascular coagulation, multiple organ dysfunction
syndrome and acute respiratory distress syndrome. On transthoracic
echocardiography, there were big vegetations on both mitral and tricuspid
valves. Consecutive blood cultures grew Staphylococcus aureus and
Staphylococcus hominis.  The diagnosis
was bilateral, multi-valvular, polymicrobial infective endocarditis. The
patient had a fulminant course and died on the fourth day of admission.  

Anahtar Kelimeler

Infective endocarditis, intravenous drug use, transthoracic echocardiography, sepsis

Kaynakça

• Abid, L., Jerbi, B., Trabelsi, I., Znazen, A., Maaloul, I., Krichène, S., Abid, D., 2010. 083 Clinical and echocardiographic characteristics of multivalvular infective endocarditis. Archives of Cardiovascular Diseases Supplements, 2, 28.
• Adler, A. G., Blumberg, E. A., Schwartz, D. A., Russin, S. J., Pepe, R., 1991. Seven-pathogen tricuspid endocarditis in an intravenous drug abuser: pitfalls in laboratory diagnosis. Chest, 99, 490-491.
• Brown, P., Levine, D., 2002. Infective endocarditis in the injection drug user. Infect Dis Clin N Am. 16, 645–665.
• Duval, X., Suty, C. S., Alla, F., Salvador-Mazenq, M., Bernard, Y., Weber, M., Leport, C., 2004. Endocarditis in patients with a permanent pacemaker: a 1-year epidemiological survey on infective endocarditis due to valvular and/or pacemaker infection. Clinical Infectious Diseases, 39, 68-74.
• García-Granja, P. E., López, J., Vilacosta, I., Ortiz-Bautista, C., Sevilla, T., Olmos, C., San Román, J. A., 2015. Polymicrobial Infective Endocarditis: Clinical Features and Prognosis. Medicine, 94, e2000.
• Habib, G., Lancellotti, P., Antunes, M. J., Bongiorni, M. G., Casalta, J. P., Iung, B., 2015. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 36, 3075-3128.
• Kim, N., Lazar, J. M., Cunha, B. A., Liao, W., Minnaganti, V., 2000. Multi-valvular endocarditis. Clin Microbiol Infect. 6, 207-212.
• Leone, S., Ravasio, V., Durante-Mangoni, E., Crapis, M., Carosi, G., Scotton, P. G., Grossi, P., 2012. Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis. Infection. 40, 527-535.
• Mathew, J., Addai, T., Anand, A., Morrobel, A., Maheshwari, P., Freels, S., 1995. Clinical features, site of involvement, bacteriologic findings, and outcome of infective endocarditis in intravenous drug users. Arch Int Med., 155, 1641-1648.
• Miró, J. M., del Rı́o, A., Mestres, C. A., 2002. Infective endocarditis in intravenous drug abusers and HIV-1 infected patients. Infect Dis Clin North Am. 16, 273-295.
• Oh, S., Havlen P.R., Hussain N., 2005. A case of polymicrobial endocarditis caused by anaerobic organisms in an injection drug user. J Gen Intern Med. 20, C1-2.
• Selton-Suty, C., Doco-Lecompte, T., Bernard, Y., Duval, X., Letranchant, L., Delahaye, F., AEPEI Study Group., 2010. Clinical and microbiologic features of multivalvular endocarditis. Curr Infect Dis Rep. 12, 237-243.
• Sousa, C., Botelho, C., Rodrigues, D., Azeredo, J., Oliveira, R., 2012. Infective endocarditis in intravenous drug abusers: an update. Eur J Clin Microbiol Infect Dis. 31, 2905-2910.
• Vilacosta, I., Blanco, C. O., Cepeda, C. S., Díaz, J. L., Durán, C. F., Calvar, J. A. S. R., 2016. Right-Heart Endocarditis. In Infective Endocarditis. Habib, G., ed. Springer International Publishing, Switzerland, pp. 207-222.