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Infective endocarditis in a heart transplant recipient.
P J Counihan1, A Yelland, M A de Belder
1Regional Cardiothoracic Unit, St. George's Hospital Medical School, London, England.
Summary
Heart transplant patients can develop complications like azathioprine-induced liver issues and septic emboli. Prompt antibiotic treatment successfully resolved a mitral valve vegetation in this case.
Area of Science:
- Cardiology
- Transplantation Medicine
- Pharmacology
Background:
- A 38-year-old male received an orthotopic heart transplant for ischemic heart disease.
- Post-transplant management included immunosuppression with azathioprine and cyclosporine.
Observation:
- The patient developed cholestatic jaundice attributed to azathioprine hepatotoxicity, requiring prednisolone supplementation.
- Seven months post-transplant, a septic right femoral embolus occurred, with transesophageal echocardiography revealing a mitral valve vegetation.
Findings:
- The mitral valve vegetation was successfully treated with antibiotics, leading to complete symptom resolution.
- The patient experienced no recurrence of symptoms and maintained normal heart function six months after the embolic event.
Implications:
- This case highlights potential drug-induced complications following heart transplantation.
- Effective antibiotic therapy can successfully manage infective endocarditis in heart transplant recipients.
- Close monitoring for adverse drug reactions and infections is crucial in post-transplant care.