Right Sided Infective Endocarditis and Mycotic Pulmonary Artery Aneurysm- A Brief Review of Important Literature

Right-sided infective endocarditis (IE) involves the infection of the endocardial surface of either the tricuspid or pulmonary valve. The tricuspid valve is involved in almost 90% of cases. Isolated right-sided infective endocarditis can present with multiple complications; the most common of which include valvular insufficiency, abscess formation, and septic pulmonary embolism. Other complications include pulmonary infarcts, pleural effusion, empyema, and pneumothorax. Mycotic pulmonary artery aneurysm is a rare complication of right-sided infective endocarditis. Staphylococcus and Streptococcus species are the most common culprits for mycotic pulmonary artery aneurysms. IV drug use and bacterial endocarditis are the two major known risk factors for mycotic aneurysm. Computerized tomography angiography is the mainstay of imaging modalities to diagnose mycotic pulmonary artery aneurysms. MRI angiography can also be used to diagnose mycotic pulmonary aneurysms, but this imaging modality is not available widely.  The mycotic pulmonary aneurysm is treated both surgically and conservatively depending on the symptoms and clinical status of the patient. The surgical approach includes emergent arterial embolization, lobectomy, resection, banding, and aneurysmectomy.