Abstract

OBON AZUARA, B.; ZALBA ETAYO, B.; GUTIERREZ CIA, I.  and  VILLANUEVA ANADON, B.. Aorto pulmonary fistula: left-sided infective endocarditis in HIV and intravenous drugs abuser patient: Review of literature. An. Med. Interna (Madrid) [online]. 2007, vol.24, n.11, pp.547-550. ISSN 0212-7199.

Infective endocarditis (IE) is the most severe complication in intravenous drug abusers (IVDAs). HIV infection increases the risk of IE in IVDAs too. IE in both population are special tendency to infect the rigth-sided heart, but unusual infective aortic valve. We report a case of HIV and IVDA patient admitted in hospital due to fever syndrome, with X-ray test normal and the first blood cultures negatives. CD4 count cell 90 mm³. It was impossible doing a transesophageal echocardiography (TEE) and transtoracic echocardiogramma (TTE) only showed a moderate aortic insufficiency with conserved systolic function. Despite using antibiotics, antifungals and highly active antirretroviral therapy, he developed ARDS, and mechanical ventilation should be performed. At that moment, TEE showed an aorto pulmonary fistula due to left-sided IE. Further cultures was undergone and only one blood culture was positive to Staphylococcus aureus. Cardiac surgery was not indicated. The patient died 3 weeks later.

Keywords : Left-sided infective endocarditis; Aorto pulmonary fistula; Staphylococcus aureus; HIV and intravenous drugs habit.

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