Work

Infective Endocarditis in an Intravenous Drug User: Clinical Challenges, Ethical Dilemmas, and Multidisciplinary Management

Year: 2025

Type: article

Abstract: . This case study examines the intricate clinical, ethical, and multidisciplinary challenges in managing a 48-year-old female with a history of IVDU, who presented with IE and multisystem complications. Initial evaluation revealed systemic septicemia with disseminated intravascular coagulation, septic emboli, and significant tricuspid valve involvement. Comprehensive management included tailored antibiotic therapy, infectious disease consultation, and palliative care integration, complicated by newly diagnosed HIV, emotional distress, and chronic pain. This report highlights the unique pathophysiology of IE in IVDU, driven by endothelial trauma and microbial colonization, often affecting the tricuspid valve. Ethical dilemmas arose when the patient, fully informed of her prognosis, elected to discontinue treatment and transition to hospice care, creating tension between respecting autonomy and ensuring beneficence. These challenges necessitated multidisciplinary collaboration to balance medical interventions with patient preferences. The case underscores the critical importance of prompt diagnosis, ethical sensitivity, and patient-centered care in managing IE in high-risk populations. It advocates for compassionate communication and respect for patient autonomy while navigating complex clinical and ethical decisions.

Source: Cureus

DOI: 10.7759/cureus.86683

Authors: Munna Hazime, Shailes Paudel, Alexander A Restum, Wisam Mnkana

Institutions: Wayne State University, Corewell Health

Language: English

Topic: Infective Endocarditis Diagnosis and Management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4411597293