Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect

A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS) and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE) had shown a PVS and no valve vegetations w...

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Main Authors: Juan Lacalzada, Cristina Enjuanes, Maria Manuela Izquierdo, Antonio Barragán Acea, Alejandro De La Rosa, Ignacio Laynez
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.4061/2010/798956
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author Juan Lacalzada
Cristina Enjuanes
Maria Manuela Izquierdo
Antonio Barragán Acea
Alejandro De La Rosa
Ignacio Laynez
author_facet Juan Lacalzada
Cristina Enjuanes
Maria Manuela Izquierdo
Antonio Barragán Acea
Alejandro De La Rosa
Ignacio Laynez
author_sort Juan Lacalzada
collection DOAJ
description A hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS) and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE) had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD), confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE). The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.
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spelling doaj-art-2f14ddca5fc44cfcb9ae02514bf40cf72025-08-20T03:55:16ZengWileyCardiology Research and Practice2090-05972010-01-01201010.4061/2010/798956798956Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal DefectJuan Lacalzada0Cristina Enjuanes1Maria Manuela Izquierdo2Antonio Barragán Acea3Alejandro De La Rosa4Ignacio Laynez5Department of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainDepartment of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainDepartment of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainDepartment of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainDepartment of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainDepartment of Cardiology, University Hospital of the Canary Islands, La Laguna, 38320 Tenerife, SpainA hypertensive 76-year-old man with severe pulmonary valve stenosis (PVS) and recent initiation of haemodialysis was referred with fever, chills, and asthenia. One month prior, he had been admitted with similar symptoms. Transthoracic echocardiography (TTE) had shown a PVS and no valve vegetations were observed. Following discharge, he was readmitted with fever and blood cultures positive for Staphylococcus haemolyticus. A new TTE revealed two pulmonary valve vegetations and a previously undetected ostium secundum-type atrial septal defect (ASD), confirmed by transesophageal echocardiography. The clinical course was uneventful with intravenous antibiotic treatment and the patient was safely discharged. This is a case of pulmonary valve infective endocarditis (IE). The incidence of right-sided IE is on the rise due to the increased number of patients using central venous lines, pacing, haemodialysis and other intravascular devices. Pulmonary valve IE is extremely rare, especially in structurally normal hearts. The case reported here, presents a combination of predisposing factors, such as severe congenital PVS, the presence of a central venous catheter, and haemodialysis. The fact that it was an older patient with severe congenital PVS and associated with a previously undiagnosed ASD, is also an unusual feature of this case, making it even more interesting.http://dx.doi.org/10.4061/2010/798956
spellingShingle Juan Lacalzada
Cristina Enjuanes
Maria Manuela Izquierdo
Antonio Barragán Acea
Alejandro De La Rosa
Ignacio Laynez
Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
Cardiology Research and Practice
title Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
title_full Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
title_fullStr Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
title_full_unstemmed Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
title_short Pulmonary Valve Infective Endocarditis in an Adult Patient with Severe Congenital Pulmonary Stenosis and Ostium Secundum Atrial Septal Defect
title_sort pulmonary valve infective endocarditis in an adult patient with severe congenital pulmonary stenosis and ostium secundum atrial septal defect
url http://dx.doi.org/10.4061/2010/798956
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