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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Vallabhajosyula, Saraschandra Esterbrooks, Dennis J. Haddad, Toufik Mahfood Sundaragiri, Pranathi Rao |
| Description | Author Affiliation: Sundaragiri PR ( Division of Hospital Internal Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.); Vallabhajosyula S ( Division of Critical Care Medicine, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.); Haddad TM ( Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA.); Esterbrooks DJ ( Division of Cardiovascular Diseases, Department of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska, USA.) |
| Abstract | Right-sided infective endocarditis (RIE) is commonly due to Staphylococcus aureus and often involves the tricuspid valve (TV). A 31-year-old man with prior intravenous drug use presented with substernal pain, cough, dyspnoea and fever. Examination revealed a febrile, tachycardic male with peripheral infective endocarditis stigmata and right-heart failure. Laboratory parameters demonstrated leucocytosis, lactic acidosis and methicillin-resistant S. aureus (MRSA) bacteraemia. Echocardiography demonstrated multiple TV echodensities and chest imaging confirmed septic emboli. The MRSA species demonstrated 'vancomycin-creep', necessitating therapy with daptomycin and ceftaroline. Owing to persistent bacteraemia and septic shock, the patient underwent TV surgery, but continued to have a poor postoperative course with subsequent death. Indications for surgical therapy of RIE are limited to the European guidelines and most data are extrapolated from left-heart disease. MRSA exhibiting vancomycin-creep portends a poorer prognosis and requires aggressive therapy. We advocate the use of ceftaroline salvage therapy with daptomycin, pending further trials. |
| Volume Number | 2015 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Endocarditis, Bacterial Microbiology Heart Valve Diseases Methicillin-Resistant Staphylococcus Aureus Drug Effects Mitral Valve Staphylococcal Infections Drug Therapy Tricuspid Valve Adult Anti-Bacterial Agents Therapeutic Use Cephalosporins Daptomycin Drug Resistance, Multiple, Bacterial Fatal Outcome Humans Male Complications Vancomycin Pharmacology Case Reports Journal Article Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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