DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.082

Pages: 2530-2532

Infective endocarditis is a serious condition that may cause atypical systemic complications beyond the cardiac structures. We report the case of a 65-year-old male admitted for fever and hemoptysis. Chest CT revealed bilateral alveolar and ground-glass opacities consistent with diffuse alveolar hemorrhage. Abdominopelvic CT demonstrated a regular thrombus located at the iliac bifurcation of the inferior vena cava, associated with a retroperitoneal fibrotic process encasing the great vessels and the development of collateral venous pathways. No edema of the lower limbs was noted. Blood cultures identified Staphylococcus aureus, and transthoracic echocardiography showed tricuspid vegetations, confirming the diagnosis of right-sided infective endocarditis. The patient received targeted intravenous antibiotic therapy and anticoagulation, leading to gradual clinical improvement. This case highlights a rare combination of complications venous thrombosis, pulmonary alveolar hemorrhage, and retroperitoneal fibrosis secondary to infective endocarditis. Radiologic imaging was essential in detecting these findings and guiding multidisciplinary management.