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Right-sided infective endocarditis — RCPSC EM MCQ

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ModerateInfectious disease emergenciesRight-sided infective endocarditisRCPSC EM

A 37-year-old injection-drug user presents with fever, pleuritic chest pain and dyspnoea. CT chest shows multiple peripheral cavitating nodules. Blood cultures are positive for Staphylococcus aureus and a new tricuspid murmur is heard. What is the most appropriate initial management?

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Correct answer: A — Start IV anti-staphylococcal antibiotics after cultures and obtain echocardiography with infectious diseases consultation

Injection-drug use, S. aureus bacteraemia, tricuspid murmur and septic pulmonary emboli indicate right-sided infective endocarditis. IV antibiotics and echocardiography are required.

Reference: Canadian infectious diseases practice; AHA infective endocarditis guidance