Isolated pulmonary valve endocarditis with rapid progression: a case report and literature review

Abstract

Background Isolated pulmonary valve endocarditis (IPE) is rare, accounting for 1.5–2% of all cases of infective endocarditis. Herein, we describe a case of isolated pulmonary valve endocarditis with rapid progression in a 28-year-old male. Unlike most patients reported previously who were cured with only anti-infective therapy, without surgery at an early stage, multiple complications occurred in this patient in less than 2 weeks. Case presentation The patient was diagnosed with pulmonary valve endocarditis with blood cultures showing Staphylococcus aureus and echocardiography revealing 2 masses (measuring 14*13 mm、11*16 mm in size). Only 12 days later, acute massive pulmonary embolism occurred. Then, repeated echocardiography revealed multiple masses attached to the pulmonary valve with severe pulmonary insufficiency and the possibility of pulmonary valve destruction. Finally, pulmonary valve replacement, vegetation removal, and right pulmonary thromboendarterectomy together with resection of the middle and lower lobes of the right lung were performed. Conclusions The role of surgery at an early stage might need to be reconsidered, and it may be viable to combine medical and surgical approaches.

Dysplastic Pulmonary Valve Infective Endocarditis With an Atrial Septal Defect—A Black Swan Event

“…Involvement of pulmonary valve (PV) is an extremely rare condition, accounting for 1.5% to 2% of all cases of IE. 1 Even rarer is the involvement of a bicuspid dysplastic PVaccompanied by an atrial septal defect (ASD), which was seen in our case along with secondary changes in the pulmonary vasculature tree in a teenager.…”

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

“…A structurally normal pulmonary valve is unlikely to be affected on its own 8–12 . Pulmonary valve experiences less shear stress than other valves due to a lower transvalvular pressure gradient.…”

“…Yuan 3 revealed overall mortality of 10.2% and surgical mortality of 7.8% for right‐sided IE. Vegetation size (>2 cm) is a predictive factor for the antibiotherapy response, and also, large and multiple vegetations pose an increased embolization risk 3–10 . Furthermore, patients with Staphylococcus aureus or fungal infection had higher mortality than with non‐ Staphylococcus aureus infections 3…”

“…4 A structurally normal pulmonary valve is unlikely to be affected on its own. [8][9][10][11][12] Pulmonary valve experiences less shear stress than other valves due to a lower transvalvular pressure gradient. This results in less risk for a valvular injury and protects the pulmonary valve against IE.…”

“…Vegetation size (>2 cm) is a predictive factor for the antibiotherapy response, and also, large and multiple vegetations pose an increased embolization risk. [3][4][5][6][7][8][9][10] Furthermore, patients with Staphylococcus…”