Abstract:
Background. Infective endocarditis represents a major public health challenge. The
incidence of infective endocarditis is 13.8 cases per 100,000 population, causing 66,300
deaths annually worldwide. Among immunocompromised patients with HIV/AIDS, the
incidence of infective endocarditis is increasing.
Objective(s). Evaluation, management, and complex treatment approach of the
immunocompromised patient (HIV-infected) with complicated infective endocarditis and
multiple comorbidities.
Materials and methods. A 45-year-old patient with HIV/AIDS, intravenous drug user was
evaluated, admitted in critical condition with fever, hemoptysis, tachycardia, and chest pain.
The diagnosis of IE, septic pulmonary embolism, sepsis and septic anemia was established.
The evaluation including ECG, echocardiography, chest X-ray, CT scan and laboratory
investigations.
Results. Initially, dual antibacterial therapy with amikacin and meropenem was
administered, according to the antibiogram. Later, on the seventh day of treatment, due to
increased leukocyte count and ESR levels, the antibacterial therapy was modified, and
gentamicin and vancomycin were added. Analgesics, iron supplements, beta-blockers, and
anticoagulants were also administered concurrently. Under treatment, the patient’s
condition improved. The patient was dynamically evaluated and monitored. On the 19th day
of treatment, with a favorable evolution, the patient was discharged with recommendations
to continue therapy in oral form.
Conclusion(s). Immunocompromised intravenous drug users are at high risk of developing
infective endocarditis. Continuous evaluation and monitoring are essential. A
comprehensive therapeutic approach and patient adherence are critical for improving
prognosis and achieving successful recovery.
