[Tricuspid valve endocarditis in a nonaddicted patient without predisposing myocardiopathy]

Right-sided endocarditis is exceptional in non-drug addict patients without previous heart disease. Few cases have been published, and its diagnosis sometimes presents a significant clinical challenge. We describe a 57-year-old patient with no history of parenteral drug addiction or vascular catheter use, who had tricuspid valve endocarditis in a morphologically normal valve. The clinical debut was characterized by acute febrile syndrome, purpura (petechia) on the legs, and oligoarthritis. This entity usually has a good prognosis and responds well to treatment, and presents certain common clinical features (persistent fever, pulmonary lesions, anemia and microscopic hematuria) that can lead the clinician to suspect the diagnosis. However, diagnosis should be based on microbiological studies (S. aureus is the organism isolated most often) and on echocardiographic findings.