[Isolated Pulmonary Valve Endocarditis Accompanying Multiple Pulmonary Embolisms:Report of a Case]

Area of Science:

• Cardiology
• Infectious Diseases
• Cardiac Surgery

Background:

• Isolated pulmonary valve infective endocarditis is a rare condition, representing 1.5% to 2.0% of all infective endocarditis cases.
• Predisposing factors are often absent in patients with pulmonary valve endocarditis.

Observation:

• A 69-year-old male presented with fever and was diagnosed with active pulmonary valve infective endocarditis.
• Blood cultures identified Streptococcus viridans; transesophageal echocardiography revealed mobile vegetation.
• Despite initial antibiotic therapy, the patient experienced recurrent fever and reduced oxygen saturation, with CT scans indicating septic pulmonary embolisms.

Findings:

• Urgent surgical intervention was necessary due to ineffective antibiotic treatment.
• Intraoperative findings revealed extensive destruction of the pulmonary valve leaflets by vegetation.
• Pulmonary valve replacement with a stented bioprosthetic valve and right ventricular outflow tract enlargement using a bovine pericardial patch were performed.

Implications:

• Successful surgical management of isolated pulmonary valve infective endocarditis can be achieved with valve replacement.
• This approach, combined with a full course of antibiotics, led to a favorable long-term outcome with no recurrence of infection for two years.
• The case underscores the importance of considering surgical intervention when antibiotic therapy fails in pulmonary valve endocarditis, especially with complications like septic pulmonary embolisms.