What's the Diagnosis? By Dr. Erica Schramm
A 28 yo male with history of IV drug use presents with fever, tachycardia and hypotension. A bedside cardiac ultrasound is performed. What's the diagnosis? (scroll down for answer)
Answer: Infective Endocarditis with mitral valve vegetation
- Vavular vegetations are seen on ultrasound as mobile masses that move independently from their respective valves
- 50% of vegetations in IV drug users involve the tricuspid valve
- Causative organisms in IV drug users are most commonly S aureus(about 50%), followed by Strep (Groups A, C, and G), enterococcus, psuedomonas, and candida
- Definitive diagnosis is made using the Duke Criteria.