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Right-Side Endocarditis: A Typical Presentation in an Atypical Patient
Right-side endocarditis (RSE) is a well-defined clinical entity, rarer than left-side endocarditis. Known risk factors include intravenous drug use or the presence of medical devices. The most frequently affected valve is the tricuspid valve. In most cases, medical treatment is enough. Surgical trea...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601156/ https://www.ncbi.nlm.nih.gov/pubmed/34820219 http://dx.doi.org/10.7759/cureus.18897 |
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author | Pais, João P Sousa, Marta Mota, Rita Cambão, Ana R Nascimento, Ana |
author_facet | Pais, João P Sousa, Marta Mota, Rita Cambão, Ana R Nascimento, Ana |
author_sort | Pais, João P |
collection | PubMed |
description | Right-side endocarditis (RSE) is a well-defined clinical entity, rarer than left-side endocarditis. Known risk factors include intravenous drug use or the presence of medical devices. The most frequently affected valve is the tricuspid valve. In most cases, medical treatment is enough. Surgical treatment is reserved for failed medical therapy or in the presence of large vegetations. Although there is a high recurrence rate in intravenous drug users (IDU), RSE has a generally good prognosis. We present the case of a 70-year-old male with no known previous diseases other than alcohol abuse. He was admitted with fever, cough, hemoptysis and a weight loss of 8 kg in two months. Chest X-ray revealed two images of condensation, one in the right pulmonary base and another in the superior right lobe. A computerized tomography of the thorax revealed a subsegmental pulmonary embolism. The patient refused hospitalization and was discharged medicated with levofloxacin and apixaban. In ambulatory, there was a decrease in size of the lesions but with a new lesion in the right hemithorax. Two months after the first episode, the patient is admitted with the same symptoms. The transthoracic echocardiogram showed a 20cm vegetation in the tricuspid valve. He was admitted to the hospital and received treatment with penicillin and gentamicin after isolation of Streptococcus mitis in the blood cultures. Surgical treatment was needed after a weak response to antibiotics, with a good evolution. |
format | Online Article Text |
id | pubmed-8601156 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-86011562021-11-23 Right-Side Endocarditis: A Typical Presentation in an Atypical Patient Pais, João P Sousa, Marta Mota, Rita Cambão, Ana R Nascimento, Ana Cureus Cardiology Right-side endocarditis (RSE) is a well-defined clinical entity, rarer than left-side endocarditis. Known risk factors include intravenous drug use or the presence of medical devices. The most frequently affected valve is the tricuspid valve. In most cases, medical treatment is enough. Surgical treatment is reserved for failed medical therapy or in the presence of large vegetations. Although there is a high recurrence rate in intravenous drug users (IDU), RSE has a generally good prognosis. We present the case of a 70-year-old male with no known previous diseases other than alcohol abuse. He was admitted with fever, cough, hemoptysis and a weight loss of 8 kg in two months. Chest X-ray revealed two images of condensation, one in the right pulmonary base and another in the superior right lobe. A computerized tomography of the thorax revealed a subsegmental pulmonary embolism. The patient refused hospitalization and was discharged medicated with levofloxacin and apixaban. In ambulatory, there was a decrease in size of the lesions but with a new lesion in the right hemithorax. Two months after the first episode, the patient is admitted with the same symptoms. The transthoracic echocardiogram showed a 20cm vegetation in the tricuspid valve. He was admitted to the hospital and received treatment with penicillin and gentamicin after isolation of Streptococcus mitis in the blood cultures. Surgical treatment was needed after a weak response to antibiotics, with a good evolution. Cureus 2021-10-19 /pmc/articles/PMC8601156/ /pubmed/34820219 http://dx.doi.org/10.7759/cureus.18897 Text en Copyright © 2021, Pais et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Cardiology Pais, João P Sousa, Marta Mota, Rita Cambão, Ana R Nascimento, Ana Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title | Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title_full | Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title_fullStr | Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title_full_unstemmed | Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title_short | Right-Side Endocarditis: A Typical Presentation in an Atypical Patient |
title_sort | right-side endocarditis: a typical presentation in an atypical patient |
topic | Cardiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8601156/ https://www.ncbi.nlm.nih.gov/pubmed/34820219 http://dx.doi.org/10.7759/cureus.18897 |
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