A massive haemothorax as an unusual complication of infective endocarditis caused by Streptococcus sanguinis

Kyoung Jin Kim, Kang Won Lee, Ju Hee Choi, Jang Wook Sohn, Ja Kim Min, Young Kyung Yoon

Research output: Contribution to journalArticle

Abstract

Objective and importance: Infective endocarditis involving the tricuspid valve is an uncommon condition, and a consequent haemothorax associated with pulmonary embolism is extremely rare. Particularly, there are no guidelines for the management of this complication. We describe a rare case of pulmonary embolism and infarction followed by a haemothorax due to infective endocarditis of the tricuspid valve caused by Streptococcus sanguinis. Clinical presentation: A 25-year-old man with a ventricular septal defect (VSD) presented with fever. On physical examination, his body temperature was 38.8 °C, and a grade III holosystolic murmur was heard. A chest X-ray did not reveal any specific findings. A transoesophageal echocardiogram showed a perimembranous VSD and echogenic material attached to the tricuspid valve. All blood samples drawn from three different sites yielded growth of pan-susceptible S. sanguinis in culture bottles. On day 12 of hospitalization, the patient complained of pleuritic chest pain without fever. Physical examination revealed reduced breathing sounds and dullness in the lower left thorax. On his chest computed tomography scan, pleural effusion with focal infarction and pulmonary embolism were noted on the left lower lung. Thoracentesis indicated the presence of a haemothorax. Intervention: Our case was successfully treated using antibiotic therapy alone with adjunctive chest tube insertion, rather than with anticoagulation therapy for pulmonary embolism or cardiac surgery. Conclusion: When treating infective endocarditis caused by S. sanguinis, clinicians should include haemothorax in the differential diagnosis of patients complaining of sudden chest pain.

Original languageEnglish
Pages (from-to)253-257
Number of pages5
JournalActa Clinica Belgica
Volume71
Issue number4
DOIs
Publication statusPublished - 2016 Jul 3

Fingerprint

Hemothorax
Endocarditis
Streptococcus
Pulmonary Embolism
Tricuspid Valve
Thorax
Ventricular Heart Septal Defects
Chest Pain
Physical Examination
Fever
Pulmonary Infarction
Chest Tubes
Respiratory Sounds
Pleural Effusion
Body Temperature
Infarction
Thoracic Surgery
Hospitalization
Differential Diagnosis
Tomography

Keywords

  • Haemothorax
  • Infective endocarditis
  • Pulmonary embolism
  • Streptococcus sanguinis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A massive haemothorax as an unusual complication of infective endocarditis caused by Streptococcus sanguinis. / Kim, Kyoung Jin; Lee, Kang Won; Choi, Ju Hee; Sohn, Jang Wook; Min, Ja Kim; Yoon, Young Kyung.

In: Acta Clinica Belgica, Vol. 71, No. 4, 03.07.2016, p. 253-257.

Research output: Contribution to journalArticle

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