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Case Reports
. 2020 Nov 29;9(12):998.
doi: 10.3390/pathogens9120998.

More than Garden Variety: Massive Vegetations from Infective Endocarditis

Christopher Radcliffe  1 , Joyce Oen-Hsiao  1   2 , Matthew Grant  1   3
Affiliations
Case Reports

More than Garden Variety: Massive Vegetations from Infective Endocarditis

Christopher Radcliffe et al. Pathogens. .

Abstract

Infective endocarditis classically involves non-sterile vegetations on valvular surfaces in the heart. Feared complications include embolization and acute heart failure. Surgical intervention achieves source control and alleviates valvular regurgitation in complicated cases. Vegetations >1 cm are often intervened upon, making massive vegetations uncommon in modern practice. We report the case of a 39-year-old female with history of intravenous drug abuse who presented with a serpiginous vegetation on the native tricuspid valve and methicillin-resistant Staphylococcus aureus bacteremia. The vegetation grew to 5.6 cm by hospital day two, and she successfully underwent a tricuspid valvectomy. Six weeks of intravenous vancomycin therapy were completed without adverse events. To better characterize other dramatic presentations of infective endocarditis, we performed a systematic literature review and summarized all case reports involving ≥4 cm vegetations.

Keywords: infective endocarditis; tricuspid valve; vegetation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Serpiginous vegetation on septal leaflet of tricuspid valve.
Figure 2
Figure 2
Cavitary lesions on computed-tomography scan of chest.
See this image and copyright information in PMC

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