A Retrospective Review: Significance of Vegetation Size in Injection Drug Users with Right-Sided Infective Endocarditis

Otome, Ohide; Guy, Stephen R.; Tramontana, Adrian R; Lane, Garry P.; Karunajeewa, Harin

doi:10.1016/j.hlc.2015.10.013

Cited by 10 publications

(11 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Right‐sided IE generally has lower mortality and morbidity rates when compared to left‐sided IE 11 . The haemodynamic impact of TV IE on the RV can correlate to findings of RV systolic dysfunction and elevated RVSP.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of embolisation has been linked to echocardiographic findings of the vegetation size and mobility, in addition to the organism involved. A change in right heart haemodynamics and evidence of the McConnell's sign (akinesis of the RV mid‐free wall with sparing of the RV apex) are echocardiographic features used when diagnosing pulmonary embolism 4,11 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A case of tricuspid valve infective endocarditis in intravenous drug use

McKinnon

2020

Sonography

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case of tricuspid valve infective endocarditis in intravenous drug use

McKinnon

2020

Sonography

View full text Add to dashboard Cite

“…As well, right-sided IE has a lower morbidity and mortality with better prognosis than left-sided IE but with greater early mortality rate [11,21,99]. Higher mortality in IDUs with right-sided IE is associated with vegetations >20 mm, fungal endocarditis, bacteremia, and older age [4,13,21,59]. To sum up, the early and complete surgical debridement of infected tissue together with microbial therapy assures a good prognosis on long term [88].…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Right-sided infective endocarditis has been mainly defined among IDUs [13][14][15]. Generally, right-sided IE comprises 5-10% of cases with IE [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…Common predisposing factors for right-sided IE are the intravenous drug users (IDUs), catheter-related infections, pacemaker or defibrillators wires, intracardiac devices (catheters for hemodialysis; tricuspid prosthetic valve), right heart catheterization, congenital heart defects, sepsis, and alcoholism [13][14][15]23]. In case of Please use Adobe Acrobat Reader to read this book chapter for free.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Infective Endocarditis in Intravenous Drug Users: Surgical Treatment

Moldovan¹,

Molnar²,

Costache³

et al. 2019

Infective Endocarditis

View full text Add to dashboard Cite

Intravenous drug use is associated with infective endocarditis. Besides, it does appear that left-sided infective endocarditis is a feature of general population, whereas right-sided infective endocarditis is common in intravenous drug users. The most common etiology of right-sided infective endocarditis in intravenous drug users is Staphylococcus aureus in about 75% followed by streptococci, Gramnegative bacilli and fungi. In case of intravenous drug users with infective endocarditis, optimal treatment strategies lack a general consensus. Additionally, the best indication and timing of surgery are debatable. To overcome these problems, the early and complete surgical debridement of infected tissue together with microbial therapy assures a good prognosis in the long term.Keywords: endocarditis, drug-associated endocarditis, intravenous drug abuser endocarditis, intravenous drug users, right heart endocarditis Infective Endocarditis 2 the right-sided IE, tricuspid valve is affected in 90% cases [21], whereas pulmonic valve represents about 10% from right-sided IE cases [3,18,24]. Up to now, isolated right-sided IE involving the pulmonary valve, the eustachian valve, interventricular septum, or right ventricular free wall have been described [17,21,25]. MicrobiologyAccording to current evidence, IE among IDUs presents a large spectrum of microbial pathogens (Table 1) [26][27][28][29][30][31].Pathogens as Pseudomonas aeruginosa, other gram-negative microorganisms, fungi, enterococci, streptococci, and polymicrobial infections occur less frequently [16]. Importantly, other pathogens noted in IDUs are oral bacteria such as Prevotella intermedia, Haemophilus parainfluenzae, S. constellatus, and E. corrodens [32][33][34][35][36].The most common etiology of right-sided IE in IDUs is Staphylococcus aureus (S. aureus) in about 75% [1,4,6,[37][38][39] followed by streptococci, Gram-negative bacilli, and fungi [40]. In fact, published data supports the involvement of S. aureus among IDUs in 40-74% cases of IE [38,41,42]. S. aureus is the most common cause of tricuspid valve endocarditis regardless of associated risk factors in IDUs [1,4,16,18,43].The incidence of negative blood cultures is reported as 2.5-31% and is associated with delayed diagnosis and treatment [44], with large vegetations [45], and with highest morbidity and mortality [16,45,46].Regarding HIV, a prevalence of HIV as high as 60% among IDUs has been reported by centers from Europe and the USA [11,40]. HIV is more common among IDUs with right-sided IE than left-sided IE [47].Polymicrobial endocarditis is characteristically for IDUs [48] and may involve microorganisms such as Bartonella spp., Candida spp., or Tropheryma whipplei [49]. The presence of E. corrodens should aware the likelihood of polymicrobial IE with embolic complications and relapses. In fact, there is a synergism between streptococci and E. corrodens [50][51][52].

show abstract

Infective Endocarditis in the Intravenous Drug Use Population at a Tertiary Hospital in Melbourne, Australia

Hilbig

Cheng

2020

Heart, Lung and Circulation

View full text Add to dashboard Cite

A Retrospective Review: Significance of Vegetation Size in Injection Drug Users with Right-Sided Infective Endocarditis

Cited by 10 publications

References 16 publications

A case of tricuspid valve infective endocarditis in intravenous drug use

A case of tricuspid valve infective endocarditis in intravenous drug use

Infective Endocarditis in Intravenous Drug Users: Surgical Treatment

Infective Endocarditis in the Intravenous Drug Use Population at a Tertiary Hospital in Melbourne, Australia

Contact Info

Product

Resources

About