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Case report: right-sided native endocarditis presenting with multiple abscess formations [care compliant].
Medicine (Baltimore) 2019; 98(24):e15961M

Abstract

INTRODUCTION

Right-sided native endocarditis is a difficult case with fewer cardiac symptoms and fewer classic signs of cutaneous vascular lesions compared with left-sided endocarditis.

PATIENT CONCERNS

A 68-year-old Taiwanese man with a history of gouty arthritis, hyperlipidemia, and adrenal insufficiency presented to our ED and complained dyspnea and low back pain for 1 month.

DIAGNOSIS ASSESSMENT

The PE showed bilateral crackles on chest auscultation and a palpable fluctuant mass over the anterior chest wall. The chest and abdominal CT scan showed multiple abscess formations involving pulmonary, sternal, and paraspinal areas. The TEE being performed and an oscillating mass over the anterior and septal leaflets of the tricuspid valve and moderate tricuspid regurgitation.

INTERVENTIONS

Only pharmacologic treatment without surgical interventions.

OUTCOMES

Deceased, patient expired on day 4 after ED visit.

CONCLUSION

This case arose as a sequela of staphylococcal endocarditis associated with persistent bacteremia and immunological dysregulation. The diagnosis of right-sided endocarditis is easily missing, multidisciplinary approach should be triggered as soon as possible, which might lead to a better outcome. Right-sided IE is still an important public health issue in southern Taiwan.

Authors+Show Affiliations

Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.Department of Physical Therapy, I-Shou University, Kaohsiung.Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan. Department of Emergency Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31192934

Citation

Chan, Tsung-Yu, et al. "Case Report: Right-sided Native Endocarditis Presenting With Multiple Abscess Formations [care Compliant]." Medicine, vol. 98, no. 24, 2019, pp. e15961.
Chan TY, Hsieh CC, Chen CL, et al. Case report: right-sided native endocarditis presenting with multiple abscess formations [care compliant]. Medicine (Baltimore). 2019;98(24):e15961.
Chan, T. Y., Hsieh, C. C., Chen, C. L., Huang, Y. Y., & Chuang, C. C. (2019). Case report: right-sided native endocarditis presenting with multiple abscess formations [care compliant]. Medicine, 98(24), pp. e15961. doi:10.1097/MD.0000000000015961.
Chan TY, et al. Case Report: Right-sided Native Endocarditis Presenting With Multiple Abscess Formations [care Compliant]. Medicine (Baltimore). 2019;98(24):e15961. PubMed PMID: 31192934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case report: right-sided native endocarditis presenting with multiple abscess formations [care compliant]. AU - Chan,Tsung-Yu, AU - Hsieh,Chih-Chia, AU - Chen,Chien-Liang, AU - Huang,Yao-Yi, AU - Chuang,Chia-Chang, PY - 2019/6/14/entrez PY - 2019/6/14/pubmed PY - 2019/6/27/medline SP - e15961 EP - e15961 JF - Medicine JO - Medicine (Baltimore) VL - 98 IS - 24 N2 - INTRODUCTION: Right-sided native endocarditis is a difficult case with fewer cardiac symptoms and fewer classic signs of cutaneous vascular lesions compared with left-sided endocarditis. PATIENT CONCERNS: A 68-year-old Taiwanese man with a history of gouty arthritis, hyperlipidemia, and adrenal insufficiency presented to our ED and complained dyspnea and low back pain for 1 month. DIAGNOSIS ASSESSMENT: The PE showed bilateral crackles on chest auscultation and a palpable fluctuant mass over the anterior chest wall. The chest and abdominal CT scan showed multiple abscess formations involving pulmonary, sternal, and paraspinal areas. The TEE being performed and an oscillating mass over the anterior and septal leaflets of the tricuspid valve and moderate tricuspid regurgitation. INTERVENTIONS: Only pharmacologic treatment without surgical interventions. OUTCOMES: Deceased, patient expired on day 4 after ED visit. CONCLUSION: This case arose as a sequela of staphylococcal endocarditis associated with persistent bacteremia and immunological dysregulation. The diagnosis of right-sided endocarditis is easily missing, multidisciplinary approach should be triggered as soon as possible, which might lead to a better outcome. Right-sided IE is still an important public health issue in southern Taiwan. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/31192934/Case_report:_right-sided_native_endocarditis_presenting_with_multiple_abscess_formations_[care_compliant] L2 - http://Insights.ovid.com/pubmed?pmid=31192934 DB - PRIME DP - Unbound Medicine ER -