[Systemic manifestations and development of GPIIbIIIa antibodies in the course of staphylococcal endocarditis. Report of a case].

Immunological complications of staphylococcal endocarditis are rare but represent a serious event in this condition. The authors report the case of acute tricuspid valve endocarditis in a 38 year old drug addict. The diagnosis was suggested by the presentation of bilateral bacterial lung abscesses with a murmur of tricuspid regurgitation, and confirmed by transthoracic and transoesophageal echocardiography. Bacteriological cultures isolated a methicillin-sensitive staphylococcal aureus. The outcome was complicated by a nephrotic syndrome associated with a glomerulonephritis by deposition of immune complexes and an autoimmune thrombocytopaenic purpura due to acquired anti-glycoprotein IIb IIIa antibodies. Antibiotic therapy led to cure without sequellae of the endocarditis, the nephrotic syndrome and the thrombocytopaenia. This case illustrates the risk of immunological complications during acute staphylococcal tricuspid valve endocarditis and also illustrates the possibility of a favourable outcome with antibiotic therapy alone. However, the potential severity of these complications indicates the need for early diagnosis and strict surveillance of this condition.