Infective endocarditis of the pulmonary valve following pulmonary artery catheterisation.
The risk of infective endocarditis following pulmonary artery catheterisation in patients with sepsis remains unquantified. Although catheter-induced endocardial and valvular injury are well recognised, valve infection is rare. A case of mixed pulmonary valve endocarditis associated with the use of a pulmonary artery catheter (PAC) in a patient with multisystem failure following liver trauma is described. This illustrates that diagnosis of infective endocarditis in critically ill patients can be difficult because concurrent illness and therapy may mimic or mask the usual presenting signs. The value of transoesophageal echocardiography in this context is emphasised.
Soding
P F
PF
Department of Anaesthesia, Addenbrooke's Hospital, Cambridge, UK.
Klinck
J R
JR
Kong
A
A
Farrington
M
M
D000328:Adult; D016470:Bacteremia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002177:Candidiasis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D016638:Critical Illness; D003428:Cross Infection / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003937:Diagnosis, Differential; D004452:Echocardiography; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013293:Enterococcus faecalis; D016469:Fungemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008099:Liver / Q000293:injuries*; D008297:Male; D011651:Pulmonary Artery; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D014947:Wounds and Injuries / Q000628:therapy