RIGHT-SIDED ENDOCARDITIS IN THE NONDRUG ADDICT

Fifteen patients with right-sided infective endocarditis during a 5 ye ar period (1985-1990) were retrospectively reviewed. Isolated tricuspi d valve involvement occurred in nine patients. Staphylococcus aureus w as the causative organism in seven cases; four were culture negative. The diagnosis was established by two-dimensional echocardiography in 1 1 patients and at postmortem in the remaining four patients who succum bed shortly after admission. Fever, tachypnoea and pneumonia were univ ersal features. A successful outcome ensued in eight patients with med ical therapy alone and in two patients who were submitted to valve rep lacement. Five patients died, two from uncontrolled infection with rep eated pulmonary emboli. Right-sided infective endocarditis should be s uspected in any pneumonic illness that complicates post-abortal infect ion or other inadequately treated sepsis. Two-dimensional echocardiogr aphy is important in diagnosis since cardiac signs are minimal at pres entation.