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Massive Hemoptysis and Recurrent Infective Endocarditis in Intravenous Drug user: A Case Report

Mutlaq Deghaiman Almutairi1, Yasser Ahmed El-Ghoneimy1, Abdulaziz Omar Alghamdi1

  • 1Surgery Division, Department of Surgery, College of Medicine, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Journal of the Saudi Heart Association
|November 6, 2020
PubMed

Insights

Intravenous drug use (IDU) can lead to rare but fatal mycotic pulmonary artery aneurysms (MPAA). Prompt identification and management of MPAA are crucial for patients with IDU to prevent life-threatening hemorrhage.

Area of Science:

  • Cardiology
  • Pulmonology
  • Infectious Diseases

Background:

  • Intravenous drug use (IDU) is a significant risk factor for infective endocarditis (IE).
  • Right-sided IE, particularly in IDU patients, can lead to serious complications.
  • Mycotic pulmonary artery aneurysms (MPAA) are rare but life-threatening sequelae of IE.

Observation:

  • A young male with a history of IDU and prior IE presented with massive hemoptysis and fever.
  • Chest CT revealed a lobulated lesion in the right lower lobe with vascular continuity.
  • The patient had a history of tricuspid valve replacement due to complicated IE.

Findings:

  • The patient's presentation was attributed to a mycotic pulmonary artery aneurysm (MPAA).
  • MPAA is a rare complication of IE in the context of intravenous drug use.
  • Rupture of MPAA can cause severe, potentially fatal hemorrhage.

Implications:

  • Highlights the severe complications of active IDU, including MPAA.
  • Emphasizes the need for prompt identification and emergent management (embolization or surgery) of MPAA.
  • Stresses the importance of counseling and rehabilitation to reduce recurrence risk in IDU patients.
Keywords:
Infective endocarditisIntravenous drug useMycotic pulmonary artery aneurysms

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