Infective endocarditis and pseudomonal septic embolizaton in a patient with HIV/AIDS

Endocarditis infecciosa y embolia séptica pulmonar por Pseudomonas aeruginosa en un paciente con VIH/SIDA

We describe the case of a 43-year-old male, diagnosed with human immunodeficiency virus infection and acquired immunodeficiency syndrome, not a user of intravenous drugs, who presented with lung cavitation consistent with septic embolization in the context of infective endocarditis of the pulmonary valve and Pseudomonas aeruginosa bacteremia, with a positive clinical and echocardiographic response to antibiotic therapy. Right-sided infective endocarditis is responsible for 5-10% of all cases of endocarditis. Although it can appear in patients with a permanent pacemaker, central venous catheter, or congenital cardiopathy, this situation is more frequently observed in addicts to intravenous drugs. While the tricuspid valve is the most common site of infection, infection of the pulmonary valve and the Eustachian valve can also be observed. In patients with human immunodeficiency virus infection, the incidence of endocarditis has decreased in the era of antiretroviral therapy; it is more common in patients with advanced immunosuppression, and causes more one-year morbidity and mortality, besides a greater risk of arterial embolizaton (pulmonary among others). The incidence of Pseudomonal infective endocarditis has been estimated at about 5% in this group of patients.