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J Cardiothorac Surg ; 14(1): 41, 2019 Feb 26.
Article in English | MEDLINE | ID: mdl-30808391

ABSTRACT

BACKGROUND: Only 4.1% of tricuspid valve IE cases require surgical intervention. The complication after tricuspid valve IE with lung abscess and empyema is rare. CASE PRESENTATION: We report the case of a 38-year-old male (an intravenous drug abuser) diagnosed with tricuspid valve IE who underwent tricuspid valve replacement. The case was complicated by multiple lung abscesses and thoracic empyema. The pathogens causing the lung abscesses and empyema were Acinetobacter baumannii complex and Candida albicans, which were different from those causing the endocarditis. After 4 weeks of antibiotic treatment, chest X-ray revealed bilateral clear lung markings with only mild blunting of the right costophrenic angle. CONCLUSION: The pathogen causing the lung abscess is not always compatible with that causing the endocarditis. Thoracoscopic incision of the abscess with 4 to 6 weeks of broad-spectrum antibiotic treatment is effective and safe.


Subject(s)
Empyema, Pleural/microbiology , Endocarditis, Bacterial/microbiology , Lung Abscess/microbiology , Substance Abuse, Intravenous/microbiology , Tricuspid Valve/surgery , Acinetobacter Infections/drug therapy , Acinetobacter Infections/microbiology , Acinetobacter Infections/surgery , Acinetobacter baumannii/isolation & purification , Adult , Anti-Bacterial Agents/therapeutic use , Candida albicans/isolation & purification , Candidiasis/drug therapy , Candidiasis/microbiology , Candidiasis/surgery , Empyema, Pleural/drug therapy , Empyema, Pleural/etiology , Empyema, Pleural/surgery , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/surgery , Heart Valve Prosthesis Implantation , Humans , Lung Abscess/drug therapy , Lung Abscess/etiology , Lung Abscess/surgery , Male , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcal Infections/surgery , Staphylococcus aureus/isolation & purification , Substance Abuse, Intravenous/complications , Thoracoscopy , Tricuspid Valve/microbiology
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