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Journal of Parenteral and Enteral Nutrition
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Case Reports

Endocarditis Complicating Parenteral Nutrition: The Value of Repeated Echocardiography

David J. Leinhardt, FRCS

Department of Surgery, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom

Chakravarthy Ragavan, MD, MRCP UK

Department of Medicine, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom

Tim O'Hanrahan, FRCS

Department of Surgery, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom

Muntzer Mughal, CHM, FRCS

Department of Surgery, University of Manchester School of Medicine, Hope Hospital, Salford, United Kingdom

Cardiac complications of parenteral nutrition are well recognized but the diagnosis of such complications may be difficult. Two-dimensional echocardiography has been shown to be of value in establishing the diagnosis of valvular vegetations and right atrial thrombus. We describe two patients who developed endocarditis while receiving parenteral nutrition via central venous catheters. In both cases initial echocardiography was normal and the tricuspid valvular vegetations were only picked up after one or more additional echocardiograms. This highlights the necessity for repeated echocardiography in patients receiving parenteral nutrition in whom infective central venous catheter complications fail to resolve quickly after appropriate treatment. (Journal of Parenteral and Enteral Nutrition 16:168—170, 1992)

Journal of Parenteral and Enteral Nutrition, Vol. 16, No. 2, 168-170 (1992)
DOI: 10.1177/0148607192016002168
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