RESUMEN
Kala azar also called as visceral leishmaniasis is a slowly progressive parasitic infection caused by protozoan of Leishmania genus transmitted by infected bite of female Phlebotomus.(1,2) Known endemic region of the world are rural India, Bangladesh, Sudan, Nepal and Brazil.(3) In India, kala azar is prevalent in hot and humid climates in eastern Indian states with most cases reported from Bihar, Bengal, Jharkhand and Uttar Pradesh,(4) with few sporadic cases reported from sub Himalayan part of north India including Uttarakhand, Jammu and Kashmir and Himachal Pradesh and few cases from Gujrat.(5,6,7) Diagnosis of kala azar is based on clinical suspicion of the disease along with diagnostic tests that include parasitic demonstration in splenic aspirate and amastigote form of LD (Leishmania donovani) bodies in bone marrow aspirate.(8) Splenic aspirate has a very good sensitivity index but is not generally the preferred diagnostic test because of its difficulty technique and risk of fatal haemorrhage, hence bone marrow aspirate is most commonly performed diagnostic test.
RESUMEN
In patients of infective endocarditis, aortic valve is most commonly involved followed by the mitral valve. Pulmonary and tricuspid valves are the least involved valves. Multiple valves can also be involved and are seen in 17-22% cases.[1] Right sided infective endocarditis is seen in approximately 10% of the total cases.[2] Isolated tricuspid valve prevalence has been reported in the range of 2.5–3.1 % and isolated pulmonary valve involvement has been reported to be 2%.[3,4] Tricuspid valve (TV) endocarditis commonly occurs in intravenous drug users (IVDU) or any abnormality of the TV. The other causes could be, patients with implantable cardiac defibrillators (ICD), central venous catheter or right sided cardiac anomalies.[5] We report a case of a previously healthy young woman, who was neither an intravenous (IV) drug user nor had any congenital heart disease, who developed TV endocarditis after an induced abortion. This case exemplifies the need for strong suspicion for right-sided IE in patients presenting with pyrexia of unknown origin (PUO) or cardiorespiratory symptoms after gynaecological interventions.