title: Infective endocarditis of the tricuspid valve in an orthotopic heart transplant recipient.
abstract: A 43-year-old orthotopic heart transplant recipient had coagulase-negative staphylococcus endocarditis 26 weeks after the operation. A diagnosis of endocarditis was confirmed and followed up by serial transoesophageal echocardiography. Treatment with intravenous gentamycin and vancomycin cured her endocarditis, and a 2.5 cm vegetation regressed significantly. She has been well since and, at 14 months after transplantation, was back to her normal activities. Although repeated blood culture yielded only intermittent light growths of coagulase-negative staphylococci, there were several positive samples. In a setting of infective features, light growths of coagulase-negative staphylococcus should be taken seriously if repeatedly positive in heart transplant recipients or other immunocompromised patients. Transesophageal echocardiography offers significant advantages over the transthoracic modality in suspected endocarditis.
authors.affiliation: Department of Medical Cardiology, Glasgow Royal Infirmary, United Kingdom.
authors.forename: M J
authors.initials: MJ
authors.lastname: Stewart
authors.forename: F
authors.initials: F
authors.lastname: Huwez
authors.forename: D
authors.initials: D
authors.lastname: Richens
authors.forename: S
authors.initials: S
authors.lastname: Naik
authors.forename: D J
authors.initials: DJ
authors.lastname: Wheatley
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D016027:Heart Transplantation / Q000000981:diagnostic imaging; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging* / Q000473:pathology; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D005839:Gentamicins; D014640:Vancomycin