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Right-sided endocarditis in the non-drug addict
1Department of Medicine, University of Natal, Medical School, Congella, Republic of South Africa.
Postgraduate Medical Journal
|August 1, 1993
Summary
Right-sided infective endocarditis, often involving the tricuspid valve and caused by Staphylococcus aureus, presents with fever and pneumonia. Early diagnosis with two-dimensional echocardiography is crucial for successful treatment outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Echocardiography
Background:
- Retrospective review of 15 patients with right-sided infective endocarditis (1985-1990).
- Focus on isolated tricuspid valve involvement, causative organisms, and diagnostic methods.
Observation:
- Fever, tachypnea, and pneumonia were universal symptoms.
- Staphylococcus aureus was the most common pathogen; some cases were culture-negative.
- Diagnosis confirmed by two-dimensional echocardiography in most patients, with others diagnosed postmortem.
Findings:
- Eight patients achieved successful outcomes with medical therapy alone.
- Two patients required valve replacement for successful treatment.
- Five patients died, two due to uncontrolled infection and pulmonary emboli.
Implications:
- Right-sided infective endocarditis should be suspected in patients with pneumonia complicating sepsis or post-abortal infections.
- Two-dimensional echocardiography is vital for diagnosis, especially when cardiac signs are subtle.
- Prompt diagnosis and treatment can improve patient outcomes in this condition.
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