Pulmonary Valve Endocarditis Research Articles

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

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

A chronic hemodialysis patient with isolated pulmonary valve infective endocarditis caused by non-albicans Candida: a rare case and literature review

BackgroundIsolated pulmonary valve infective endocarditis caused by Candida is rare in chronic hemodialysis patients. The 2009 Infectious Diseases Society of America guidelines suggest the combined use of surgery and antibiotics to treat candidiasis; however, successful nonsurgical treatment of Candida endocarditis has been reported.Case presentationA 63-year-old woman with end-stage kidney disease was admitted to our hospital after experiencing disorientation for 5 days. The patient was permanently bedridden because of depression, and denied active intravenous drug use. She received maintenance hemodialysis through a tunneled-cuffed catheter. An initial blood culture grew Candida guilliermondii without other bacteria. Subsequent blood cultures and tip culture of tunneled-cuffed catheter also grew C. guilliermondii, even after caspofungin replaced fluconazole. A 1.2-cm mobile mass was observed on the pulmonary valve. Surgical intervention was suggested, but the family of the patient declined because of her multiple comorbidities. The patient was discharged with a prescription of fluconazole, but she died soon after.ConclusionOur patient is the first case with isolated pulmonary valve endocarditis caused by C. guilliermondii in patients with uremia. Hematologic disorders, in addition to long-term central venous catheter use, prolonged antibiotic intravenous injection, and congenital cardiac anomaly, predispose to the condition. The diagnosis “isolated” pulmonary IE is difficult, and combing surgery with antifungal antibiotics is the appropriate therapeutic management for Candida related pulmonary IE.

Pneumococcal pulmonary valve endocarditis

Pulmonary valve endocarditis is a rare type of infective endocarditis (IE). Streptococcus pneumoniae is a pathogen that is uncommonly associated with IE. A 50 year-old male was referred to us after an incidental echocardiographic finding of a pulmonary valve vegetation. The patient had a recent admission for drainage of a scrotal abscess from which S. pneumoniae was isolated, complicated by hospital acquired pneumonia and pulmonary embolism. Analysis using polymerase chain reaction of the surgically resected mass revealed signs of 16S ribosomal DNA consistent with S. pneumoniae infection. This was an extremely rare case of pneumococcal pulmonary valve IE presenting entirely asymptomatically in the absence of any known risk factors.

A rare case of Mycobacterium abscessus subspecies abscessus prosthetic valve endocarditis and the clinical importance of inducible erm(41) gene testing

A 56-year-old man with a history of injection drug use and two prior episodes of native valve infective endocarditis presented with dyspnoea on exertion. Our preliminary work-up revealed bacteraemia with...

Surgical case of isolated pulmonary valve endocarditis in a patient without predisposing factors

We report a case of isolated pulmonary valve endocarditis in a 47-year-old woman without predisposing factors. She had episodes of low-grade fever and non-productive cough and was initially diagnosed with bacterial pneumonia. With antibiotic treatment, her condition improved transiently, but she had repeated respiratory events. Forty days after her first visit, she complained of severe dyspnea. Echocardiography revealed a large vegetation adhering to the pulmonary valve and she was diagnosed with isolated pulmonary valve endocarditis. Surgical treatment was selected because antibiotic treatment was not effective. The main pulmonary artery was transected above the annulus and the infected valve was excised. To avoid contact of the prosthetic valve with the infected pulmonary annulus, a stentless bioprosthesis was interposed between the transected parts of the pulmonary trunk. Two years after the surgery, the patient is stable with no sign of infection.

Ventricular Septal Defect with Pulmonary Valve Endocarditis with Vegetation - Successful Surgical Treatment in Apollo Hospitals Dhaka

Background: Pulmonary valve vegetation with ventricular septal defect needs early surgical intervention.Case presentation: A 21 years old man got admitted in Apollo Hospitals Dhaka, with the complaints of dyspnoea on exertion since childhood. Echocardiogram revealed a large perimembranous ventricular septal defect, moderate pulmonary stenosis, vegetation attached with pulmonary valve leaflet moving during systole & diastole. During operation ventricular septal defect was closed by dacron patch. Large vegetation was excised from anterior cusp of pulmonary valve. A perforation in right cusp of pulmonary valve was repaired with pericardial patch. Transesophageal Echocardiogram revealed well functioning ventricles and no leakage through the repaired Ventricular Septal Defect and pericardial patch in pulmonary valve leaflet.Result: Culture Sensitivity from vegetation showed no growth and histopathological examination revealed tissue consistent with vegetation of Pulmonary Valve. Post- operative echocardiogram showed no residual shunt or vegetation. The patient was discharged on 8th post operative day in good general condition and is doing well till now.Conclusion: Pulmonary valve endocarditis with vegetation with ventricular septal defect is a rare association. Early surgical intervention gives good outcome.Pulse Vol.9 January-December 2016 p.69-72

Atrial Septal Defect with Pulmonary Valve Endocarditis- An Unusual Friendship

Atrial Septal Defect with Pulmonary Valve Endocarditis- An Unusual Friendship

Single Ventricle with Infective Endocarditis and Brain Abscess: A Rare Case Report

Right-sided valve endocarditis is usually uncommon. Pulmonary valve endocarditis with septic emboli as the complication of a rare congenital heart disease is even unusual. Herein, we report a case of a 27-year-old male congenital cyanotic heart disease with pulmonary valve endocarditis presenting with 5 days history of fever and headache. Echocardiography demonstrated double-inlet left ventricle with hypoplastic right ventricle with discordant origin of great arteries. In addition, multiple mobile vegetations in the pulmonary valve are also seen. Brain imaging revealed cerebral abscess. The occurrence of pulmonary valve endocarditis and cerebral abscess in a case of single ventricle is very rarely reported.

A late presentation of pulmonary valve endocarditis following closure of patent ductus arteriosus in the childhood: A case report

Background: Infective endocarditis is a microbial infection of the endothelial surface of heart and great vessels frequently involving Mitral and Aortic valve. Pulmonary valve endocarditis leading to Severe Pulmonary Regurgitation is extremely rare and is often diagnosed late due to non specificity of symptoms. We intend to report such a case to bring the attention of everyone the long term consequences of Pulmonary Regurgitation. Here we also describe method of replacing Pulmonary valve with Bioprosthetic Aortic valve. Methods: We describe the technique of replacement of pulmonary valve with Bioprosthetic Aortic valve in case of severe Pulmonary regurgitation. Result: The patient successfully underwent replacement of both Pulmonary and Tricuspid valve with bioprosthetic valve and was discharged from the hospital on seventh post operative day. During successive follow up there was considerable improvement in exercise tolerance and she being presently in NYHA class II. Conclusion: Pulmonary valve replacement with bioprosthetic tissue valve should be considered for patients with Pulmonary regurgitation and volume overload of Right ventricle. Emphasis should be on Right ventricle dilatation before setting of RV dysfunction rather then severity of Pulmonary regurgitation alone.

Tricuspid and pulmonary valve endocarditis associated with double-chambered right ventricle

We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.

Cardiopulmonary manifestations of isolated pulmonary valve infective endocarditis demonstrated with cardiac CT

Right-sided infective endocarditis involving the pulmonary valve is rare. This pictorial essay discusses the use and findings of cardiac CT combined with delayed chest CT and noncontrast chest CT of pulmonary valve endocarditis. Cardiac CT is able to show the full spectrum of right-sided endocarditis cardiopulmonary features including manifestations that cannot be demonstrated by echocardiography.

Native Pulmonic Valve Endocarditis due to Mycobacterium fortuitum: A Case Report and Literature Review.

Endocarditis secondary to Mycobacterium fortuitum is a rare entity often involving prosthetic valves and rarely native valves. Pulmonic valve endocarditis secondary to any organism is rare. We report the first case of native pulmonic valve endocarditis secondary to M. fortuitum and a literature review of native valve M. fortuitum endocarditis.

Fungal pulmonary valve endocarditis masquerading as a pulmonary embolism.

Septic pulmonary emboli (SPE) can be a difficult clinical entity to distinguish from thromboembolic pulmonary embolism (TPE) in a patient with history of IV drug abuse (IVDA). We present a case of a patient who presented with failure to thrive and presumed diagnosis of recurrent PE that ultimately was discovered to have fungal pulmonary valve endocarditis resulting in a right ventricular outflow obstruction. This required replacement of the pulmonary valve and repair of the right ventricular outflow tract. This case highlights difficulty in differentiating pulmonary valve endocarditis with septic emboli from chronic PE in a patient with a complex medical history.

Pulmonic Valve Repair in a Patient with Isolated Pulmonic Valve Endocarditis and Sickle Cell Disease.

A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter. Chest computerized tomography showed multiple bilateral pulmonary nodular opacities consistent with septic emboli. Transthoracic and transesophageal echocardiograms revealed a large echodensity on the pulmonic valve requiring vegetation excision and pulmonic valve repair. In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion. Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.

A Case Report of Isolated Pulmonary Valve Endocarditis

A Case Report of Isolated Pulmonary Valve Endocarditis

Infective endocarditis of a transcatheter pulmonary valve in comparison with surgical implants

BackgroundMelody valved stents (Medtronic Inc, Minneapolis, Minnesota, USA) have become a very competitive therapeutic option for pulmonary valve replacement in patients with congenital heart disease. After adequate prestenting of the...

Pulmonic Valve Endocarditis Complicating Streptococcus pneumoniae Community-Acquired Pneumonia

Infective endocarditis is most often seen affecting the left side of the heart, with the pulmonary valve being the least frequently involved valve. The most common organisms responsible for infective endocarditis are Staphylococcus aureus and Streptococcus viridans. Here we report a rare case of pulmonary valve endocarditis due to Streptococcus pneumoniae, a rare pathogen for this setting. The clinical features, presentation, and review of the literature are discussed.

Pulmonary artery compression in a Thoroughbred colt due to a mediastinal abscess

SummaryIn the case presented, a young horse was referred for further evaluation based on a presumptive diagnosis of pulmonic valve endocarditis, bronchopneumonia and a cranial mediastinal abscess based on thoracic ultrasound, echocardiography and clinical signs. However, further echocardiographic evaluation revealed that the abscess was compressing the right ventricular outflow track causing outflow obstruction, a murmur associated with right ventricular outflow tract obstruction (acquired pulmonic stenosis) and right ventricular hypertrophy. Vegetative endocarditis was not present. Medical management was unsuccessful, but surgical drainage and long‐term antimicrobial therapy were effective and the horse returned to a successful racing career.

Aspergillus endocarditis in a paediatric patient after a cardiac surgery, associated with septic pulmonary embolism and pulmonary hypertension

We report a rare case of pulmonary prosthetic valve endocarditis due to Aspergillus fumigatus, associated with septic pulmonary embolism and secondary pulmonary hypertension, in a 4-year-old boy with surgically corrected tetralogy of Fallot. The diagnosis and treatment of Aspergillus endocarditis remains highly challenging. The best therapeutic option for chronic thromboembolic pulmonary hypertension due to an infectious thromboembolic event is highly debatable and the results are poor.

Melody® pulmonary valve bacterial endocarditis: Experience in four pediatric patients and a review of the literature

The objectives of this manuscript are two-fold: (a) to describe the clinical characteristics and management of four pediatric patients with bacterial endocarditis (BE) after Melody pulmonary valve implantation (MPVI); and (b) to review the literature regarding Melody pulmonary valve endocarditis. There are several reports of BE following MPVI. The clinical course, BE management and outcome remain poorly defined. This is a multi-center report of four pediatric patients with repaired tetralogy of Fallot (TOF) and BE after MPVI. Clinical presentation, echocardiogram findings, infecting organism, BE management, and follow-up assessment are described. We review available literature on Melody pulmonary valve endocarditis and discuss the prognosis and challenges in the management of these patients. Of our four BE patients, two had documented vegetations and three showed worsening pulmonary stenosis. All patients remain asymptomatic after medical treatment (4) and surgical prosthesis replacement (3) at follow-up of 17 to 40 months. Analysis of published data shows that over half of patients undergo bioprosthesis explantation and that there is a 13% overall mortality. The most common BE pathogens are the Staphylococcus and Streptococcus species. Our case series of four pediatric patients with repaired TOF confirms a risk for BE after MPVI. A high index of suspicion for BE should be observed after MPVI. All patients should be advised to follow lifelong BE prophylaxis after MPVI. In case of BE, surgery should be considered for valve dysfunction or no clinical improvement in spite of medical treatment.