Tricuspid valve endocarditis following over-the-counter intravenous injection of skin-whitening products

Intravenous drug use, central catheters and intracardiac devices are known predispositions to right-sided infective endocarditis (IE). We report a case of tricuspid IE caused by Acinetobacter seifertii and Enterobacter bugandensis as a result of intravenous use of skin-whitening products bought online. Clinical implications and pharmaceutical regulations are briefly discussed.

Aortic root abscess – a deadly complication of UTI-induced infective endocarditis

Aortic root abscess and endocarditis should be suspected in patients with bradycardia and sepsis. We present a case of a 76 year old male who presented with urinary tract infection and sepsis and developed bradycardia and ventricular stand still during hospital admission. Transthoracic echocardiogram was unrevealing; transesophageal echocardiogram showed prosthetic valve dehiscence and aortic root abscess, intracardiac fistula, and tricuspid valve endocarditis. This case highlights the importance of suspecting endocarditis in patients with sepsis and known source of infection, especially if blood cultures do not clear or conduction abnormalities develop.

Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis

Background In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect. Methods From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis. Results Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group. Conclusion Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.