Téma:  Case Studies

Unusual tricuspid and mitral valve endocarditis caused by streptococcus viridans in a patient with ventricular septal defect

Juraj Dúbrava, Jaroslava Richterová, Ivan Ferák, Patrik Podaný, Anton Šoral

Tricuspid valve infective endocarditis occurs in industrialized countries except for the community of drug abusers only sporadically. We describe herein a case report of a 48-year-old man with known ventricular septal defect, admitted because of anasarca, fluidothorax, severe renal failure, severe anaemia and fever. Echocardiography revealed several vegetations on tricuspid valve and its chordae with the biggest size 18 x 19 mm. The blood cultures identified Streptococcus viridans. Because of poor global condition and extremely high risk of the cardiosurgery the patient was treated conservatively with vancomycin (due to allergy to penicillin). The treatment was unsuccessful and 14 days later we found an extension of endocarditis to originally normal mitral valve and the patient died.This case report is exceptional from the point of view of two aspects: probable causal relationship with ventricular septal defect and unusual etiology of the tricuspid valve infective endocarditis – Streptococcus viridans.

Ročník 2005  Témy časopisu Internal medicine 2 / 2005

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