A Case Report of Recurrent Pneumothorax: A Rare Complication of Tricuspid Valve Endocarditis

Intravenous drug use (IVDU) is a recognized risk factor for infective endocarditis (IE), with potential mechanisms involving direct bacterial introduction through the needle puncture. Bilateral pneumothorax, an under-reported yet significant complication of IE, was first documented in 1990. Only eleven cases of spontaneous pneumothorax (PTX) associated with septic pulmonary embolism from IE have been reported. We present a 26-year-old female with a history of IE and a prior pneumothorax. She was transferred to our facility for recurrent IE, confirmed by echocardiography and blood cultures. After an initial stable clinical course, on the fifth morning, she developed new-onset dyspnea, later diagnosed with bilateral PTX that required bilateral chest tube placement. Left-sided PTX resolved quickly, while the right-sided PTX persisted for 11 more days. Following clinical improvement, the patient was discharged on the 18th day. Promptly identifying this rare complication was crucial for the patient's survival.