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Isolated Pulmonic Valve Endocarditis
Jevon Samaroo-Campbell1, Arsalan Hashmi1, Rajat Thawani1
1Department of Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
The American Journal of Case Reports
|February 5, 2019
Summary
This case highlights extremely rare isolated pulmonary valve endocarditis (PVE) in a healthy patient. Early diagnosis is crucial, as initial symptoms mimicked the flu and transthoracic echocardiograms were normal.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Case Reports
Background:
- Infective endocarditis (IE) carries a high mortality rate despite treatment.
- Right-sided endocarditis is uncommon (5-10%), with isolated pulmonary valve endocarditis (PVE) being exceptionally rare (<2%).
- Prompt diagnosis and management are vital for preventing complications and reducing mortality.
Observation:
- A patient with hypertension, no prior valvular disease, developed flu-like symptoms post-dental cleaning.
- Initial diagnosis was influenza; blood cultures revealed S. mitis bacteremia with no clear source.
- A normal transthoracic echocardiogram (TTE) initially missed the condition.
Findings:
- Transesophageal echocardiogram revealed a large vegetation on the pulmonic valve.
- This case represents PVE in an otherwise healthy individual without typical risk factors.
- Diagnosis was challenging due to absent peripheral stigmata and a normal initial TTE.
Implications:
- Current guidelines lack specific recommendations for right-sided endocarditis management and surgical intervention.
- This case underscores the importance of considering rare diagnoses even with normal initial investigations.
- Further research is needed to address diagnostic and therapeutic strategies for PVE.
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