New NICE abortion care guidance: what does it mean for antibiotic use?

S, Shahi M, Khan A, Rijal Y, Gurung B, Kurmi RN. Infective endocarditis of tricuspid valve following septic abortion: a case report

Introduction

Right-sided infective endocarditis (IE) in non-intravenous drug users is a rare finding. IE of the tricuspid valve is considered an important but uncommon complication in patients with a recent history of obstetric and gynecological procedures.

Case presentation

We report a case of a 28-year-old female with IE of the tricuspid valve with a prior history of dilatation and curettage. The echocardiography revealed two mobile vegetation in the septal leaflet of the tricuspid valve with severe eccentric tricuspid regurgitation. Blood culture was positive for Staphylococcus aureus. The patient was started on intravenous (i.v.) antibiotics with supportive treatments and improved over the days.

Clinical discussion

Infection can get access to the venous system via pelvic veins after the septic obstetric and gynecological procedure and subsequently to the right side of the heart. Different studies have highlighted the role of prophylactic antibiotics in significantly reducing post-abortal infections. In our patient, the disease was diagnosed on the basis of clinical, echocardiographic, and blood culture findings, and the patient responded well to i.v. antibiotics and supportive care under close monitoring in the coronary care unit.

Conclusion

It is important for healthcare providers to be aware of the risk factors and symptoms associated with right-sided IE for early diagnosis and treatment. Appropriate antibiotic prophylaxis and adherence to sterile techniques can help to prevent IE.