A Case of Left-Sided Infective Endocarditis Secondary to Intravenous Drug Use Resulting in Septic Renal Emboli

Methicillin-sensitive Staphylococcus aureus (MSSA) is a gram-positive, coagulase-positive coccus implicated in the pathogenesis of infective endocarditis (IE) due to intravenous drug use (IDU). The tricuspid valve is the most commonly affected valve; however, there is an increased incidence of mitral valve involvement. In this case report, we present a 41-year-old female with no known past medical history but a social history significant for IDU who presented with MSSA bacteremia, sepsis, and IE with vegetations on the mitral valve. This patient had no predisposing immunocompromising conditions; however, her repeated IDU history increased her risks for IE. This patient subsequently developed fatal complications of renal septic emboli. She was treated with broad-spectrum intravenous antibiotics, vancomycin, and ceftriaxone, which was de-escalated to nafcillin following blood culture sensitivity data results. She was ultimately transferred to another facility for surgical management of her condition. We write this case report to bring awareness to this rare but fatal condition and to highlight the presentation of mitral valve vegetations.