Unexpected isolated native pulmonary valve endocarditis; really benign as thought?

Abstract

Background: Isolated pulmonary valve endocarditis is extremely rare, accounting for <2% of cases. Major predisposing factors are intravenous drug use, implanted cardiac devices, congenital heart diseases, and central venous catheters. Most patients respond well to appropriate antibiotherapy.Aim: We report a case with an isolated native pulmonary valve endocarditis due to methicillin-resistant staphylococcus-aureus infection which developed after a tooth abscess in a previously healthy non-drug user young male. After one week antibiotherapy, surgery was required due to acute severe pulmonary insufficiency and right heart-failure. After the operation, he had a multi-organ failure despite veno-arterial extracorporeal membrane oxygenation, antibiotherapy, and other supportive treatments, therefore the case concluded with mortality. Discusion and Conclusion:Our case showed that pulmonary valve endocarditis may occur in patients without risk factors in case of portal of entry for bacteremia and it may carry worse prognosis than previously known. Virulence of the microorganism and vegetation size are the major predictors of prognosis. Pulmonary valve endocarditis should be kept in mind even in patients without any known risk factors.

Pulmonary Valve Endocarditis during and beyond Euro ENDO Registry: A Single Center Case Series

“…Agrawal et al [ 30 ] reported the successful replacement of the pulmonary valve with a bioprosthetic valve and patch closure of the ASD in patient with PVIE. In an opposite case report, autopsy showed a congenital bicuspid pulmonary valve, affected by infective endocarditis [ 31 ], and even after this, a case of cardiac surgery-complicated [ 32 ] multi-organ failure concluded with mortality. Dhakam et al [ 33 ] reported a case of PVIE treated conservatively with lethal outcome after prolonged hospital stay.…”