A Case of Intra-Cardiac Right-Sided Mural Infective Endocarditis Associated with Ventricular Septal Defect Despite Prophylactic Antibiotics: A Case Report

Lin, Tina; Santos, Maria; Aboltins, Craig; Chiu, Herman; Van Gaal, William; Wong, Chiew

doi:10.1016/j.hlc.2010.05.003

« Previous Next »Heart, Lung and Circulation
Volume 19, Issue 9 , Pages 566-571, September 2010

A Case of Intra-Cardiac Right-Sided Mural Infective Endocarditis Associated with Ventricular Septal Defect Despite Prophylactic Antibiotics: A Case Report

Tina Lin, MBBS
- Department of Cardiology, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
- Corresponding author. Fax: +61 8405 8405.
Maria Santos, MD
- Department of Cardiology, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
- Fax: +61 8405 8405.
Craig Aboltins, FRACP
- Department of Infectious Diseases, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
Herman Chiu, FACEM
- Department of Emergency Medicine, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
William Van Gaal, FRACP MD
- Department of Cardiology, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
- Fax: +61 8405 8405.
Chiew Wong, FRACP
- Department of Cardiology, Northern Health, 185 Cooper Street, Epping, Victoria 3076, Australia
- Fax: +61 8405 8405.

Received 30 September 2009; received in revised form 22 April 2010; accepted 3 May 2010.

Bacterial endocarditis secondary to jet lesions from congenital heart disease is not uncommon, and has been reported on numerous occasions in the literature. These cases usually involve one or more cardiac valves. Our case is that of isolated intracardiac right-sided mural infective endocarditis associated with ventricular septal defect. Importantly, this patient had preceding dental work treated with antibiotic prophylaxis. This case highlights bacteraemia secondary to dental instrumentation versus routine oral hygiene. His presentation was predominantly that of respiratory symptoms and sepsis, and he was culture negative throughout his admission. The lesion was detailed on echocardiography and transoesophageal echocardiography, and treated conservatively. He has subsequently been referred for VSD closure.

Keywords: Endocarditis, Intracardiac right mural, Ventricular septal defect, Antibiotic prophylaxis guidelines