Native tricuspid valve endocarditis following central venous catheterization

.A 31 year old woman was admitted with weakness, fatigue, dyspnea and fewer. Detailed questioning on past medical history she had undergone of central venous cannulation two weeks previously. Transthoracic echocardiography (TTE) showed a large mobile mass (21×18 mm) attached to the atrial surface of the anterior leaflet of the tricuspid valve with mild tricuspid regurgitation. The diagnosis of infective endocarditis was made and confirmed with blood cultures positive for Staphylococcus aureus septicemia. Vancomycin and gentamycin treatment was started. Repeat TTE on weeks 2 and 4 revealed no changes in the mass. Open heart surgery was performed. Vegetation attached to the tricuspid valve was excited. Tricuspid annuloplasty was performed. Follow up echocardiography disappeared mass and minimal tricuspid regurgitation demonstrated. The patient made an uneventful recovery.