MRSA tricuspid valve infective endocarditis with multiple embolic lung abscesses treated by combination therapy of vancomycin, rifampicin, and sulfamethoxazole/trimethoprim

Abstract

A 26-year-old pregnant woman who was an intravenous drug user (IDU) was admitted to our hospital for the treatment of tricuspid valve infective endocarditis (IE) and lung abscesses due to methicillin-resistant Staphylococcus aureus (MRSA). We started to treat her with vancomycin (VCM) alone and then in combination with rifampicin (RFP), but her condition did not improve. Then we added sulfamethoxazole/trimethoprim (SMZ/TMP) to VCM and RFP. After that, she improved rapidly. In Japan, there are very few reports about tricuspid valve IE caused by MRSA in IDUs. This case suggests that the combination of VCM, RFP, and SMZ/TMP may be effective for the treatment of severe MRSA infections.

Pulmonary complications observed in patients with infective endocarditis with and without injection drug use: An analysis of the National Inpatient Sample

“…The impact of cardiovascular complications, such as valvular damage, cardiac abscess, conduction abnormalities, and stroke on IE outcomes are well-studied [1][2][3][4][5]. However, a recent literature search regarding the effect and management of pulmonary complications (empyema, lung abscesses, and septic pulmonary emboli) on outcomes of IE consists mainly of case reports [6][7][8][9][10][11][12][13][14][15]. There are no large scale epidemiological, retrospective, or prospective studies on the subject and the epidemiology of IE-PC is largely unknown.…”

Clinical outcome of postoperative surgical site infections in patients with posterior thoracolumbar and lumbar instrumentation

“…Nemoto et al reported that MRSA prosthetic arthritis was successfully treated with a combination of vancomycin and rifampicin for 17 weeks, followed by sulfamethoxazole/trimethoprim [46]. Fujino et al also reported a case of MRSA tricuspid valve infective endocarditis treated with combination therapy [47]. In this study, 12 patients (2.2%) were infected with either MRSA or MRSE.…”

Drug use-related right-sided infective endocarditis complicated by empyema and bronchopleural fistula

“…A few cases of recurrent pulmonary abscesses and empyema have been reported in the literature 3 8–10. Moreover, there are even fewer documented cases of resultant bronchopleural fistula in the literature 6 11.…”