{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:53:45Z","timestamp":1777312425281,"version":"3.51.4"},"reference-count":22,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025]]},"abstract":"\n Introduction:<\/jats:bold>\n The eustachian valve (EV) is a remnant of the right sinus venosus valve. It remains different in size and shape without much impact on adult life. In 5% to 10% of all endocarditis, are seen in the right side of the heart is involved, which is rare compared to the left side of the heart. Bacteremia, central venous catheter, heart implants, and drug abuse increase the risk of EV vegetation and right heart endocarditis. We are reporting a case of EV endocarditis in patients with Fournier\u2019s gangrene and septic shock.\n <\/jats:p>\n \n Case Presentation:<\/jats:bold>\n A 45-year-old male patient was admitted into the surgical intensive care unit with Fournier\u2019s gangrene, septic shock, and acute kidney injury (AKI). The patient was managed by invasive ventilation, noradrenaline, vasopressin, and renal replacement therapy. He developed\n Escherichia coli<\/jats:italic>\n bacteremia and candidemia. We added meropenem and antifungal to the therapy. The transthoracic echocardiography showed EV vegetation and thread-like vegetation in the right coronary sinus, which was confirmed with transesophageal echocardiography. With aggressive therapies, the patient recovered from septic shock, organ dysfunction and was successfully liberated from invasive ventilation. The patient was discharged home on day 27. The antibiotics and antifungal were continued for 6 weeks. Two weeks after discharge, the follow-up echocardiogram was normal, and he was doing well.\n <\/jats:p>\n \n Discussion:<\/jats:bold>\n Eustachian valve endocarditis is rare, and should be treated with appropriate, culture- and sensitivity-guided antibiotics and or antifungal therapy for 6 weeks. The outcome of EV vegetations of endocarditis is good. The reported mortality is up to 17%. The independent risk factors associated with mortality are AKI, the Charlson comorbidity index, congestive heart failure, larger vegetation, and central nervous system involvement.\n <\/jats:p>\n \n Conclusion:<\/jats:bold>\n The presence of larger EV, along with\n E. coli<\/jats:italic>\n (ESBL) bacteremia and fungemia, increases the risk of right-sided endocarditis, which is rarely reported. Our patient was diagnosed early, received appropriate antimicrobial treatment for a sufficient duration, resulting in a better outcome. A high index of suspicion, along with early diagnosis and culture-guided 6-week antimicrobial therapy, will improve the patient\u2019s outcomes.\n <\/jats:p>","DOI":"10.5339\/qmj.2025.93","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T09:30:38Z","timestamp":1757928638000},"source":"Crossref","is-referenced-by-count":0,"title":["Eustachian valve endocarditis in patients with Fournier\u2019s gangrene and septic shock: A rare case and a literature review"],"prefix":"10.5339","volume":"2025","author":[{"given":"Ahmed Sifeeldein Ahmed","family":"Idris","sequence":"first","affiliation":[{"name":"Hamad General Hospital, Doha, Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umme","family":"Nashrah","sequence":"additional","affiliation":[{"name":"Deccan College of Medical Sciences\/Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umm E.","family":"Amara","sequence":"additional","affiliation":[{"name":"Deccan College of Medical Sciences\/Hyderabad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nissar","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Surgical Intensive Care\/Hamad Medical Corporation, Doha, Qatar*Correspondence: Ahmed Sifeeldein Ahmed Idris dr.ahmedseif1997@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"key":"CIT0001","series-title":"Newsl Can Soc Hist Med","first-page":"9","article-title":"Eustachius and his anatomical plates","volume":"1","author":"Roberts\n \nKB","year":"1979"},{"issue":"(4):","key":"CIT0002","series-title":"J Cardiothorac Vasc Anesth","first-page":"1215\u201324","article-title":"The anatomy of the eustachian valve-navigating the implications for right-sided surgical and transcatheter cardiac interventions","volume":"35","author":"Bruce\n \nL","year":"2021"},{"issue":"(1):","key":"CIT0003","series-title":"Australas J Ultrasound Med","first-page":"29\u201335","article-title":"Eustachian valve endocarditis: Case report and literature review","volume":"21","author":"Chan Pei Loon\n \nJ","year":"2017"},{"key":"CIT0004","series-title":"Am J Case Rep","first-page":"e936279-1","article-title":"A case series of eustachian valve endocarditis: an under-diagnosed and rare entity","volume":"23","author":"Salehin\n \nS","year":"2022"},{"issue":"(4):","key":"CIT0005","series-title":"Proc (Bayl Univ Med Cent)","first-page":"572\u20133","article-title":"Eustachian valve endocarditis","volume":"32","author":"Fan\n \nJ","year":"2019"},{"issue":"(4):","key":"CIT0006","series-title":"Clin Infect Dis","first-page":"518\u201326","article-title":"The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: updating the Modified Duke Criteria","volume":"77","author":"Fowler\n \nVG","year":"2023"},{"issue":"(6):","key":"CIT0007","series-title":"Am Heart J","first-page":"1037\u201340","article-title":"Eustachian valve endocarditis: is it worth searching for?","volume":"142","author":"Rom\u00e1n\n \nJAS","year":"2001"},{"key":"CIT0008","series-title":"Ann Med Surg (Lond)","first-page":"102705","article-title":"Extended spectrum beta lactamase producing Escherichia coli eustachian valve infective endocarditis","volume":"69","author":"Ireifej\n \nB","year":"2021"},{"key":"CIT0009","article-title":"Eustachian valve endocarditis","author":"PubMed"},{"issue":"(3):","key":"CIT0010","series-title":"J Cardiovasc Dis Res","first-page":"181\u20135","article-title":"Eustachian valve endocarditis: Rare case reports and review of literature","volume":"2","author":"Alreja\n \nG","year":"2011"},{"issue":"(39):","key":"CIT0011","series-title":"Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. 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Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. 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