1. Massive haemoptysis in an intravenous drug user with infective tricuspid valve endocarditis
- Author
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Meinrad Gawaz, Christian Herdeg, Jürgen Hetzel, Martin Heuschmid, Andreas Henning, Tobias Walker, Iris Müller, Christine S. Zürn, Claus Hann von Weyhern, Georg Lamprecht, Gerhard Ziemer, Karin Müller, and Htun Patrik
- Subjects
Adult ,medicine.medical_specialty ,Hemoptysis ,Aneurysm, Ruptured ,Pulmonary Artery ,Risk Assessment ,Article ,Aneurysm ,Tricuspid Valve Insufficiency ,medicine.artery ,Internal medicine ,medicine ,Endocarditis ,Humans ,cardiovascular diseases ,Pneumonectomy ,Substance Abuse, Intravenous ,Postoperative Care ,Tricuspid valve ,business.industry ,General Medicine ,Mycotic aneurysm ,Staphylococcal Infections ,medicine.disease ,Right pulmonary artery ,Echocardiography, Doppler ,Surgery ,Anti-Bacterial Agents ,medicine.anatomical_structure ,Treatment Outcome ,Infective endocarditis ,Pulmonary artery ,Cardiology ,cardiovascular system ,Female ,business ,Tomography, X-Ray Computed ,Aneurysm, Infected ,Echocardiography, Transesophageal ,Follow-Up Studies - 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.
- Published
- 2012