title: Massive haemoptysis in an intravenous drug user with infective tricuspid valve endocarditis.
abstract: Major causes of morbidity in intravenous drug users are infections. In infective endocarditis, the tricuspid valve is mainly involved. Masses can cause septic embolisms and, in rare cases, they are associated with mycotic aneurysms of pulmonary arteries that lead to severe haemorrhage. We report the case of a young woman with a history of intravenous drug abuse and prolonged infective tricuspid valve endocarditis. Initially, echocardiography showed large masses on the anterior leaflet of the tricuspid valve and severe tricuspid regurgitation; blood cultures revealed staphylococcus and streptococcus species. Eight months after initial diagnosis, she presented with severe haemoptysis and fever. CT revealed a ruptured mycotic aneurysm of the right pulmonary artery. Lobectomy was performed immediately. Postoperatively, the patient fully recovered. After continued antibiotic treatment, follow-up examinations showed negative echocardiographic findings and blood cultures results.
authors: Kardiologie, Medizinische Klinik Universitaetsklinikum Tuebingen, Tuebingen, Germany.
authors: Karin Anne Lydia
authors: KA
authors: Müller
authors: Christine Stefanie
authors: CS
authors: Zürn
authors: Htun
authors: H
authors: Patrik
authors: Martin
authors: M
authors: Heuschmid
authors: Jürgen
authors: J
authors: Hetzel
authors: Andreas
authors: A
authors: Henning
authors: Iris Irmgard
authors: II
authors: Müller
authors: Georg
authors: G
authors: Lamprecht
authors: Claus
authors: C
authors: von Weyhern
authors: Christian
authors: C
authors: Herdeg
authors: Gerhard
authors: G
authors: Ziemer
authors: Meinrad Paul
authors: MP
authors: Gawaz
authors: Tobias
authors: T
authors: Walker
mesh_terms: D000328:Adult; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015150:Echocardiography, Doppler / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006469:Hemoptysis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011013:Pneumonectomy / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents