A rare case of isolated streptococcal pulmonary valve endocarditis diagnosed with repeated echocardiography

Kurnicka, Katarzyna; Nowakowski, P.; Pruszczyk, Piotr

doi:10.20452/pamw.4152

Cited by 1 publication

(1 citation statement)

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“…The role of surgical intervention has been discussed in persistent bacteremia especially with resistant organisms, complications such as abscess formation, and recurrent septic pulmonary embolism. Hemodynamic un-stability, vegetations >20 mm, and Staphylococcus infection are also considered indications for surgical consultation in right-sided endocarditis [13][14][15][16][17]. As described above in our patient's clinical course, surgical intervention was deferred because she responded well and appropriately with medical management.…”

Section: Discussionmentioning

confidence: 71%

Isolated Pulmonary Valve Endocarditis

Acharya

Anwar

Iannuzzi

et al. 2020

Cureus

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Infective endocarditis involving the right side of the heart is typically associated with IV drug abuse and chronic indwelling catheters which commonly involve the tricuspid valve. Isolated pulmonary valve endocarditis (PVE) is a rare clinical entity. We report a rare case of a young woman with a history of end-stage renal disease (ESRD) on hemodialysis through tunneled catheter presenting with persistent coagulase-negative staphylococcus (CoNS) epidermidis bacteremia despite being on appropriate treatment with IV vancomycin for two weeks. Because of the persistent bacteremia, a transesophageal echocardiogram was performed and it revealed a thickened pulmonary valve with 1.8 cm vegetation in the left posterior cusp. She was successfully treated with IV daptomycin course for a total of six weeks. The recommended management for PVE is usually medical treatment with IV antibiotics gauged according to sensitivities of the cultures. Our article highlights the fact that the decision to manage it medically versus surgically can propose a challenge as the guidelines are not very robust.

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