Background: This case underscores the severe complications that can result from neglected infectious diseases, particularly in countries affected by war and disaster, where health services and follow-up for suspected illnesses are compromised. Right-sided endocarditis including tricuspid valve injury is rare, mainly seen in drug users. Delayed diagnosis and treatment can result in severe complications. Case Presentation: A young Caucasian man complains of chronic inflammatory symptoms and has recently developed unexplained pulmonary abscesses. Through various diagnostic investigations (TTE, TEE, CT), it was found that he has endocarditis affecting the tricuspid valve. Conclusion: Infective emboli are considered one of the significant complications of cases of infective endocarditis, which require collaborative efforts among various medical specialties to ensure good outcomes. Timing for surgical intervention in mechanical complications from neglected injuries is crucial, as global guidelines dictate the ideal surgical timing.
References
[1]
Shmueli, H., Thomas, F., Flint, N., Setia, G., Janjic, A. and Siegel, R.J. (2020) Right-Sided Infective Endocarditis 2020: Challenges and Updates in Diagnosis and Treatment. Journal of the American Heart Association, 9, e017293. https://doi.org/10.1161/jaha.120.017293
[2]
Abubakar, H., Rashed, A., Subahi, A., Yassin, A.S., Shokr, M. and Elder, M. (2017) Angiovac System Used for Vegetation Debulking in a Patient with Tricuspid Valve Endocarditis: A Case Report and Review of the Literature. Case Reports in Cardiology, 2017, Article 1923505. https://doi.org/10.1155/2017/1923505
[3]
Akinosoglou, K., Apostolakis, E., Marangos, M. and Pasvol, G. (2013) Native Valve Right Sided Infective Endocarditis. European Journal of Internal Medicine, 24, 510-519. https://doi.org/10.1016/j.ejim.2013.01.010
[4]
Delgado, V., Ajmone Marsan, N., de Waha, S., Bonaros, N., Brida, M., Burri, H., et al. (2023) 2023 ESC Guidelines for the Management of Endocarditis. European Heart Journal, 44, 3948-4042. https://doi.org/10.1093/eurheartj/ehad193
Schranz, A.J., Fleischauer, A., Chu, V.H., Wu, L. and Rosen, D.L. (2019) Trends in Drug Use-Associated Infective Endocarditis and Heart Valve Surgery, 2007 to 2017. Annals of Internal Medicine, 170, 31-40. https://doi.org/10.7326/m18-2124
[7]
Mahfuzah, M.N., Amanina, F., Vicky, A., Fairuz, S. and Zahrul, L.A. (2024) Pseudomonas aeruginosa Infective Endocarditis and Biofilm Challenges: Confronting the Barriers. Medical Journal of Malaysia, 79, 232.
[8]
Kim, J.B., Ejiofor, J.I., Yammine, M., Ando, M., Camuso, J.M., Youngster, I., et al. (2016) Surgical Outcomes of Infective Endocarditis among Intravenous Drug Users. The Journal of Thoracic and Cardiovascular Surgery, 152, 832-841. https://doi.org/10.1016/j.jtcvs.2016.02.072
[9]
Straw, S., Baig, M.W., Gillott, R., Wu, J., Witte, K.K., O’regan, D.J., et al. (2019) Long-term Outcomes Are Poor in Intravenous Drug Users Following Infective Endocarditis, Even after Surgery. Clinical Infectious Diseases, 71, 564-571. https://doi.org/10.1093/cid/ciz869