Medical College of Georgia at Augusta University, Augusta, GA, USA.
Division of Infectious Diseases, Department of Medicine, Medical College of Georgia, WellStar MCG Health, Augusta, GA, USA.
J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241265917. doi: 10.1177/23247096241265917.
Multivalvular endocarditis is a rare and potentially fatal complication that can occur in people who inject drugs. Currently, there are few cases that have been studied or reported in literature. A complication of this manifestation that worsens prognosis and treatment is the distribution of septic emboli throughout the body which highlights the dissemination of the infection. There are no specific guidelines on the treatment of multivalvular endocarditis, but its complexity can present challenges in administering medical and surgical treatment. In this case of a 37-year-old man with infective endocarditis of 3 valves, a comprehensive work-up found septic emboli in the lungs, kidneys, ribs, spine, and brain with ophthalmologic involvement that resulted in visual impairment. This case highlights important complications that can occur with septic emboli and management of these issues using a multidisciplinary approach including the treatment of substance use disorder.
多瓣膜心内膜炎是一种罕见且可能致命的并发症，可发生于吸毒人群。目前，文献中研究或报道的病例很少。这种表现的一个使预后和治疗恶化的并发症是全身感染性栓子的分布，这突出了感染的传播。对于多瓣膜心内膜炎的治疗尚无具体指南，但由于其复杂性，在实施药物和手术治疗时可能会遇到挑战。本例为一名 37 岁男性，患有三尖瓣感染性心内膜炎，全面检查发现肺部、肾脏、肋骨、脊柱和大脑中有感染性栓子，且眼部受累导致视力障碍。该病例强调了感染性栓子可能发生的重要并发症，以及采用多学科方法（包括治疗物质使用障碍）来管理这些问题。
