Right-sided infective endocarditis (RSIE) represents 5–10% of all cases of infective endocarditis (IE). Its optimal diagnosis, management and prognosis remain a challenge for cardiologist.

Our study aimed to determine clinical features and prognosis of RSIE.

From January 1998 to March 2015, we retrospectively reported all patients admitted for infective endocarditis in Cardiology B department. The modified Duke criteria were used for diagnosis. Clinical findings and prognosis of RSIE were compared to those of left-sided IE (LSIE).

Among the 235 patients, 20 (8.5%) patients had RSIE including seven (35%) cases of IE on cardiac device. Mean age was 30±19.5 years. Sixty-five percent was female. They had higher incidence of congenital heart disease (35% vs. 7.9%, P<0.0001). Cutaneous root was implicated in 30% of cases. Blood culture was more frequently positive (70% vs. 44.9%, P=0.015). Staphylococcus species was the most common causative pathogen compared to LSIE (78.6% vs. 43.6%, P=0.012). Detection of vegetation on ultrasound was similar in both groups but vegetation size was higher in RSIE (15.7±8.6mm vs. 11.6±5.4mm, P=0.026). Pulmonary embolism was higher in RSIE. The occurrence of atrioventriculair block (degree 2 and 3) was higher (5% vs. 0.5% P=0.043) in RSIE and only 8.6% of them required implantable pacemaker. Heart failure, cerebrovascular events, need of cardiac surgery and in-hospital mortality were not different between the two groups.

This study showed that RSIE is relatively rare and differs with regards to epidemiology, clinical characteristics and complications compared with LSIE.