A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review

Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is...

Full description

Saved in:
Bibliographic Details
Main Authors: Shahzad Khan, Athanasios Smyrlis, Dmitry Yaranov, David Oelberg, Eric Jimenez
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Cardiology
Online Access:http://dx.doi.org/10.1155/2015/291079
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849473338643054592
author Shahzad Khan
Athanasios Smyrlis
Dmitry Yaranov
David Oelberg
Eric Jimenez
author_facet Shahzad Khan
Athanasios Smyrlis
Dmitry Yaranov
David Oelberg
Eric Jimenez
author_sort Shahzad Khan
collection DOAJ
description Infective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.
format Article
id doaj-art-c8e938feb6534459af7cdf1deeac8d88
institution Kabale University
issn 2090-6404
2090-6412
language English
publishDate 2015-01-01
publisher Wiley
record_format Article
series Case Reports in Cardiology
spelling doaj-art-c8e938feb6534459af7cdf1deeac8d882025-08-20T03:24:11ZengWileyCase Reports in Cardiology2090-64042090-64122015-01-01201510.1155/2015/291079291079A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature ReviewShahzad Khan0Athanasios Smyrlis1Dmitry Yaranov2David Oelberg3Eric Jimenez4Danbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USADanbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USADanbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USADanbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USADanbury Hospital, Western Connecticut Health Network, 187 Willow Springs, New Milford, CT 06776, USAInfective endocarditis (IE) is an infection of the endocardium that involves valves and adjacent mural endocardium or a septal defect. Local complications include severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. If left untreated, IE is generally fatal. Diagnosing IE can be straightforward in patients with the typical oslerian manifestations such as bacteremia, evidence of active valvulitis, peripheral emboli, and immunologic vascular phenomena. In the acute course, however, the classic peripheral stigmata may be few or absent, particularly among intravenous drug abuse (IVDA) patients in whom IE is often due to a S. aureus infection of right-sided heart valves. We present a complicated case of a very aggressive native aortic valve MSSA (methicillin sensitive Staphylococcus aureus) IE in a young adult male with a past medical history of bicuspid aortic valve and IV drug abuse. His clinical course was complicated by aortic valve destruction and development of third-degree AV block, as well as an aorto-left atrial fistula requiring emergent operation for AV replacement and patch repair. The patient required two reoperations for recurrent endocarditis and its complications.http://dx.doi.org/10.1155/2015/291079
spellingShingle Shahzad Khan
Athanasios Smyrlis
Dmitry Yaranov
David Oelberg
Eric Jimenez
A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
Case Reports in Cardiology
title A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
title_full A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
title_fullStr A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
title_full_unstemmed A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
title_short A Complicated Case of Triple Valve Infective Endocarditis in an IV Drug User with a Bicuspid Aortic Valve Requiring Three Separate Salvage Operations: A Case Report and Literature Review
title_sort complicated case of triple valve infective endocarditis in an iv drug user with a bicuspid aortic valve requiring three separate salvage operations a case report and literature review
url http://dx.doi.org/10.1155/2015/291079
work_keys_str_mv AT shahzadkhan acomplicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT athanasiossmyrlis acomplicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT dmitryyaranov acomplicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT davidoelberg acomplicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT ericjimenez acomplicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT shahzadkhan complicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT athanasiossmyrlis complicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT dmitryyaranov complicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT davidoelberg complicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview
AT ericjimenez complicatedcaseoftriplevalveinfectiveendocarditisinanivdruguserwithabicuspidaorticvalverequiringthreeseparatesalvageoperationsacasereportandliteraturereview