Infective endocarditis--a forgotten cause for heart insufficiency in elderly. Case report.

Area of Science:

• Cardiology
• Infectious Diseases

Background:

• Right heart infective endocarditis (IE) is uncommon, particularly in elderly individuals without prior cardiac history or risk factors.
• Subacute IE occurrence rates are similar across age groups, contrasting with the rarity of right-sided IE in the elderly.

Observation:

• A 75-year-old patient presented with nonspecific septic symptoms and edema, later diagnosed with right heart valve IE.
• The patient had received a 7-day course of antibiotics prior to hospital admission, complicating adherence to diagnostic criteria.
• Despite incomplete adherence to Duke criteria, the patient showed excellent response to targeted antibiotic therapy.

Findings:

• Tricuspid valve IE is infrequently reported, with unknown sources in approximately 80% of cases.
• While pediatric cases link Staphylococcus aureus septicemia to upper respiratory infections, adult etiologies remain less defined.
• This case underscores iatrogenic factors potentially influencing IE presentation and diagnosis.

Implications:

• Isolated right-sided endocarditis should be considered in the differential diagnosis of febrile syndromes, even in patients without typical risk factors like pacemakers or intravenous drug use (IVDU).
• Further research is warranted to elucidate the specific sources of infection for right-sided IE.
• Early recognition and appropriate treatment are crucial for favorable outcomes in rare IE cases.