title: Right-sided endocarditis secondary to a peritoneovenous shunt.
abstract: A 51-year-old woman with a peritoneovenous shunt for refractory ascites presented with three months of increasing fatigue, exertional dyspnea, night sweats and positive blood cultures. Imaging revealed multiple pulmonary emboli. Transthoracic&nbsp; chocardiography demonstrated moderate tricuspid regurgitation and a large pedunculated right atrial mass attached to the interatrial septum. The echocardiographic appearance remained unchanged after one month of antibiotic therapy and&nbsp; nticoagulation. Intraoperatively, the mass was easily excised and the grossly abnormal tricuspid valve replaced. Pathology revealed endocarditis with multiple bacterial colonies, and fibromyxoid changes consistent with postinflammatory valve disease.
authors.affiliation: University of British Columbia, Vancouver. jwille@interchange.ubc.ca
authors.forename: Jennifer
authors.initials: J
authors.lastname: Higgins
authors.forename: Hossein
authors.initials: H
authors.lastname: Shayan
authors.forename: Guy
authors.initials: G
authors.lastname: Fradet
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000379:methods; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000009:adverse effects*; D010538:Peritonitis / Q000150:complications*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000473:pathology / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D000925:Anticoagulants