title: Right-sided infective endocarditis with a ruptured sinus of Valsalva and multiple septic pulmonary emboli in a patient with atopic dermatitis.
abstract: We herein report the case of 34-year-old woman with acute tricuspid valve infective endocarditis (IE) associated with a ruptured sinus of Valsalva and multiple septic pulmonary emboli. She had no history of medical problems, except for atopic dermatitis (AD). Blood cultures identified methicillin-sensitive Staphylococcus aureus. Despite the administration of two months of antibiotic therapy, the patient experienced recurrent pulmonary emboli and developed heart failure due to a left-to-right shunt, whereas the area of vegetation did not change in size. She subsequently underwent surgery for shunt closure and tricuspid valve replacement. The AD was thought to be the cause of the patient's bacteremia, which consequently resulted in aggressive right-sided IE.
authors.affiliation: Department of Cardiology, Matsuyama Red Cross Hospital, Japan.
authors.forename: Koshin
authors.initials: K
authors.lastname: Horimoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kubo
authors.forename: Hidenori
authors.initials: H
authors.lastname: Matsusaka
authors.forename: Hironori
authors.initials: H
authors.lastname: Baba
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Umesue
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage; D015377:Cilastatin / Q000008:administration & dosage; D000077728:Cilastatin, Imipenem Drug Combination; D003876:Dermatitis, Atopic / Q000276:immunology / Q000382:microbiology*; D004338:Drug Combinations; D004697:Endocarditis, Bacterial / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006333:Heart Failure / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D015378:Imipenem / Q000008:administration & dosage; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D012850:Sinus of Valsalva / Q000382:microbiology / Q000601:surgery*; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D000890:Anti-Infective Agents; D004338:Drug Combinations; D005839:Gentamicins; D015377:Cilastatin; D015378:Imipenem; D000077728:Cilastatin, Imipenem Drug Combination