Why the study?
Infective endocarditis is a serious and potentially fatal complication of central venous line placement in patients with diseased hearts.
Highlights the severe and potentially fatal risk of infective endocarditis complicating central venous line placement, particularly when a guide wire is retained.
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CVL placement may precipitate tricuspid endocarditis in ischemic cardiomyopathy; hypothesis-generating and should not yet change practice.
Abstract Infective endocarditis is a serious and potentially fatal complication of central venous line (CVL) placement in patients with diseased hearts. A man of 59 was admitted because of fever and dyspnea of 5 days duration. He was a known case of ischemic cardiomyopathy with frequent admissions to a local hospital. Two months earlier, a CVL was placed in right subclavian vein for drug administration. On examination, he was febrile and hypotensive with a systolic murmur in tricuspid and mitral areas. CVL- guide wire was radiographically visible. White blood cells and C-reactive protein were elevated. Echocardiography showed big vegetation on tricuspid valve (TV), severe mitral and tricuspid regurgitation and dilated left ventricle whilst coronary angiography revealed 3-vessel disease. Antibiotic therapy was followed by an open heart surgery during which the guide wire and valve vegetation were removed, TV was repaired, mitral valve was replaced and coronary artery bypass grafting was performed. Culture of blood, valve tissue and guide wire grew Staphylococcus Epidermidis. Despite intensive medical and surgical therapy, the patient succumbed on the 4th postoperative day.
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Mirza et al. (2019) studied this question.
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