[Tricuspid valve endocarditis in a nonaddicted patient without predisposing myocardiopathy].
Right-sided endocarditis is exceptional in non-drug addict patients without previous heart disease. Few cases have been published, and its diagnosis sometimes presents a significant clinical challenge. We describe a 57-year-old patient with no history of parenteral drug addiction or vascular catheter use, who had tricuspid valve endocarditis in a morphologically normal valve. The clinical debut was characterized by acute febrile syndrome, purpura (petechia) on the legs, and oligoarthritis. This entity usually has a good prognosis and responds well to treatment, and presents certain common clinical features (persistent fever, pulmonary lesions, anemia and microscopic hematuria) that can lead the clinician to suspect the diagnosis. However, diagnosis should be based on microbiological studies (S. aureus is the organism isolated most often) and on echocardiographic findings.
Varona
José F
JF
Departamento de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid, Spain. jfva_varona@yahoo.com
Guerra
Juan M
JM
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002437:Cefazolin / Q000008:administration & dosage / Q000627:therapeutic use; D003023:Cloxacillin / Q000008:administration & dosage / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002437:Cefazolin; D003023:Cloxacillin