# A Case of Relapse Pseudomonas aeruginosa Tricuspid Valve Endocarditis After AngioVac Vegectomy and Antibiotic Treatment in a Patient Using Intravenous Drugs

## TL;DR

A rare case of Pseudomonas aeruginosa infective endocarditis relapsed in a drug user despite surgery and antibiotics.

## Contribution

Reports a rare relapse of P. aeruginosa tricuspid valve endocarditis after AngioVac treatment and antibiotic therapy.

## Key findings

- P. aeruginosa IE relapsed despite AngioVac vegetation debulking and six weeks of IV antibiotics.
- Patient had septic pulmonary emboli and no recent intravenous drug use during treatment.
- Case highlights challenges in treating rare P. aeruginosa IE and potential for relapse.

## Abstract

Infective endocarditis (IE) is a bloodstream infection affecting the valves of the heart. IE is highly associated with morbidity and mortality if not properly managed. Pseudomonas aeruginosa (P. aeruginosa) as a cause of IE is extremely rare. This is a case of IE involving a male patient with a history of intravenous drug use (IVDU), secondary to P. aeruginosa, with associated relapse of bacteremia and native tricuspid valve endocarditis, complicated by septic pulmonary emboli, despite undergoing recent vegetation debulking using the AngioVac system (AngioDynamics, Inc., New York, USA) along with six weeks of IV antibiotics and no IVDU since then being on treatment.