Isolated Pulmonary Valve Endocarditis on an Undiagnosed Congenital Heart Disease in a Young Adult: A Rare Clinical Entity
M. Njie *
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
P. M. Mulendele
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Selmaoui
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Jiddou
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco.
A. Assklou
Cardiologist Attaché, Ibn Rochd University Hospital, Casablanca, Morocco.
M. Haboub
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Professor at the Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
A. Drighil
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Professor at the Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
R. Habbal
Department of Cardiology P37, Ibn Rochd University Hospital, Casablanca, Morocco and Professor at the Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Isolated pulmonary valve endocarditis (PVE) is a rare condition that accounts for 1.5–2% of all reported cases of endocarditis. Herein, we describe a rare case of isolated pulmonary valve endocarditis with a fortuitous discover of a congenital heart disease in a young adult subject. Unlike other cases of right sided endocarditis, we treated our patient both medically and surgically.
Case Presentation: The patient was diagnosed with an isolated pulmonary valve endocarditis after blood cultures confirming the presence of Abiotrophia defectiva, a germ difficult to cultivate whilst the echocardiographic revealed a vegetation mass measuring 8mm long alongside with the discovery of a severe pulmonary valve stenosis and a large atrial septal defect (ASD) of 39mm wide. Septic pulmonary emboli were the first clinical manifestation in our patient. Both medical and surgical treatment was indicated based on dual antibiotics, removal of the vegetation, valvulotomy and closure of the ASD.
Conclusion: Both medical and early surgery therapy should be considered in patient with right sided endocarditis associated with congenital heart disease for better clinical outcome.
Keywords: Isolated pulmonary valve endocarditis, pulmonary valve stenosis, atrial septal defect, Abiotrophia defective, transthoracic echocardiography
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