We report a case of an intravenous drug user who already had a tricuspid bioprosthesis implanted after an infective endocarditis with massive tricuspid regurgitation one year ago. Now he presents with a large mass on the atrial side of the bioprosthesis that led to obstruction; hemocultures contained Enterococcus faecalis. After one-week therapy with antibiotics, aspirin and enoxaparin the mass...

The practice of cardiac auscultation is a critical tool used by physicians to detect alterations in the cardiovascular system. A case of both left and right sided endocarditis initially detected by electronic auscultation in a woman with a history of injection drug use is described. The electronic stethoscope, with the ability to amplify heart sounds, established the presence of both a systolic...

Recent European guidelines have emphasized the association of vegetation size with embolic risk in endocarditis (1). On these grounds, left-sided vegetations >1 cm, and right-sided vegetations >2 cm are considered to be an indication for surgery. In this issue of iJACC, investigators from the MEDIC (Multicenter Electrophysiologic Device Cohort) registry report the importance of vegetation size ...

If William Osler were alive today he would no doubt remark on the fundamental change in the nature of the disease that he originally described. Staphylococcal endocarditis in injection drug users is now the dominant form of the disease in many urban communities where there is a high incidence of injection drug use and homelessness. At our institution (a tertiary care, university affiliated hosp...