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Septic pulmonary and systemic embolism in tricuspid endocarditis
Takuro Nii1, Hideto Yoshikawa1, Taichi Okabe1
1Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
BMJ Case Reports
|November 26, 2014
Summary
Septic pulmonary embolism from tricuspid valve endocarditis can lead to paradoxical systemic embolism. Surgical intervention for tricuspid valvuloplasty and patent foramen ovale closure resolved complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Vascular Surgery
Background:
- Tricuspid valve endocarditis can cause septic pulmonary embolism.
- Systemic septic emboli are a rare but serious complication.
Observation:
- A 28-year-old woman with fever was diagnosed with septic pulmonary embolism.
- She developed Janeway lesions and cerebral infarctions, indicating systemic embolism.
- Transoesophageal echocardiography revealed a patent foramen ovale (PFO) with a right-to-left shunt.
Findings:
- The patient had septic pulmonary embolism secondary to tricuspid valve endocarditis.
- A patent foramen ovale facilitated paradoxical systemic embolism.
- Surgical tricuspid valvuloplasty and PFO closure were successful.
Implications:
- Patent foramen ovale should be considered in patients with septic pulmonary embolism and systemic embolic events.
- Early surgical management can prevent severe complications.
- This case highlights the importance of identifying intracardiac shunts in infective endocarditis.
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