https://doi.org/10.4081/hls.2026.14132
An unusual case of multivalvular infective endocarditis complicated by staphylococcal pneumonia in an intravenous drug user: a case report
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 7 January 2026
Infective Endocarditis (IE) is a rare but potentially lethal infection of the endocardium and heart valves, native or prosthetic. Staphylococcus aureus-associated IE was identified as the most common cause of IE and is an independent predictor of mortality. Most cases of IE are left-sided and involve a single valve. Here we report a case of Staphylococcus aureus bivalvular endocarditis (MVE) in a patient with a history of intravenous drug use and provide a literature review of MVE identification, treatment, and prognosis. Our patient underwent a 4-week course of intravenous antibiotic therapy for infective endocarditis. Serial Transthoracic Echocardiography (TTE) during hospitalization demonstrated a reduction in the size of the vegetations on both the mitral and tricuspid valves. Upon clinical stabilization, the patient was transitioned to oral antibiotic therapy for an additional two weeks. At discharge, the patient was in stable condition and was advised to continue outpatient follow-up. Routine surveillance with TTE every three months was recommended to monitor for recurrence or progression.
Downloads
1. Fowler VG, Miro JM, Hoen B, et al. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA 2005;293:3012-21.
2. Cabell CH, Jollis JG, Peterson GE, et al. Changing patient characteristics and the effect on mortality in endocarditis. Arch Intern Med 2002;162:90-4.
3. Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 2015;132:1435-86.
4. Momtazmanesh S, Saeedi Moghaddam S, Malakan Rad E, et al. Global, regional, and national burden and quality of care index of endocarditis: the global burden of disease study 1990–2019. Eur J Prev Cardiol 2022;29:1287-97.
5. Mostaghim AS, Lo HYA, Khardori N. A retrospective epidemiologic study to define risk factors, microbiology, and clinical outcomes of infective endocarditis in a large tertiary-care teaching hospital. SAGE Open Med 2017;5:2050312117741772.
6. Wang A, Gaca JG, Chu VH. Management considerations in infective endocarditis: a review. JAMA 2018;320:72-83.
7. Alvarez Zaballos S, Gonzalez Ramallo V, Quintana E, et al. Multivalvular endocarditis: a rare condition with poor prognosis. J Clin Med 2022;11:4736.
8. Hoen B, Alla F, Selton-Suty C, et al. Changing profile of infective endocarditis: Results of a 1-year survey in France. JAMA 2002;288:75-81.
9. Bouza E, Menasalvas A, Munoz P, et al. Infective endocarditis: A prospective study at the end of the twentieth century – new predisposing conditions, new etiologic agents and still a high mortality. Medicine (Baltimore) 2001;80:298-307.
10. Haverkos HW, Lange WR. Serious infections other than human immunodeficiency virus among intravenous drug abusers. J Infect Dis 1990;161:894-902.
11. Miró JM, del Río A, Mestres CA. Infective endocarditis in intravenous drug abusers and HIV-1 infected patients. Infect Dis Clin North Am 2002;16:273-95.
12. Hecht S, Berger M. Right-sided endocarditis in intravenous drug users. Prognostic features in 102 episodes. Ann Intern Med 1992;117:560-6.
13. Goodman Meza, Weiss RE, Gamboa S, et al. Long term surgical outcomes for infective endocarditis in people who inject drugs: a systematic review and meta-analysis. BMC Infect Dis 2019;19:918.
14. Revilla A, López J, Vilacosta I, et al. Clinical and prognostic profile of patients with infective endocarditis who need urgent surgery. Eur Heart J 2007;28:65-71.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.