Right sided infective endocarditis: About 13 cases, review of literature

Abstract

The right sided infective endocarditis is a rare disease, it represents 5- 10% of the total number of Infective endocarditis events, mainly occurring in patients with congenital heart disease, patients carrying intravascular catheters or intracardiac devices, and it's frequently seen in injection drug users. The care of these patients is a medical and surgical challenge. We report 13 cases of right sided infective endocarditis. Our patients were seven female, six men with an age ranging between 23 and 68 years. They all had a predisposing factor: pacemaker, venous catheter, recent cardiac surgery and drug abuse. Blood cultures were positive in 10 cases, with the identification of Staphylococcus aureus in 7 patients. Cardiac ultrasound was the key examination to display vegetations and quantify tricuspid regurgitation. Treatment was given according to international recommendations, and was based primarily on a bi-bactericidal antibiotic therapy adapted to the isolated germ; surgical treatment was proposed in three cases with favorable evolution in two patients. There was a two case of death resulting from septic shock. One in the following of cardiac surgery and the other occurred early and did not respond to medical treatment. The outcome was favorable for the other cases. Although rare, tricuspid endocarditis is not exceptional and occurs in a context that favors. The operative indication is rarely hemodynamic, but rather infectious to eradicate an antibiotic resistant focus. Overall prognosis of remains better than the left side.