Isolated Pulmonary Valve Endocarditis in a Patient with Aortic Regurgitation and Patent Foramen Ovale;Report of a Case

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 69; no. 7; p. 537
• Main Authors: Doi, Toshio, Gyoten, Takayuki, Sakata, Kimimasa, Nagura, Saori, Yamashita, Akio, Fukahara, Kazuaki, Kotoh, Keiju, Yoshimura, Naoki
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.07.2016
• Subjects: Aged, 80 and over; Aortic Valve Insufficiency - complications; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - surgery; Cardiac Surgical Procedures - methods; Echocardiography; Endocarditis - diagnostic imaging; Endocarditis - microbiology; Endocarditis - surgery; Foramen Ovale, Patent - complications; Foramen Ovale, Patent - diagnostic imaging; Foramen Ovale, Patent - surgery; Heart Valve Diseases - diagnosis; Heart Valve Diseases - etiology; Heart Valve Diseases - microbiology; Heart Valve Diseases - surgery; Heart Valve Prosthesis Implantation - methods; Humans; Male; Methicillin-Resistant Staphylococcus aureus - isolation & purification; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - surgery; Severity of Illness Index; Staphylococcal Infections; Treatment Outcome
• ISSN: 0021-5252

Isolated pulmonary valve endocarditis is an extremely rare clinical condition. Here, we report a case of pulmonary valve endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA). An 84-year-old man with a history of aortic regurgitation and patent foramen ovale was admitted to our hospital due to fever of unknown origin for 4 weeks' duration. MRSA was detected in his blood cultures. Transthoracic echocardiography demonstrated a mobile vegetation attached to the pulmonary valve, moderate to severe aortic regurgitation, and patent foramen ovale with left-to-right shunt. After 30-days' treatment with vancomycin, gentamicin and rifampicin, he defervesced and blood cultures became negative. At surgery, a large vegetation was still attached to the pulmonary valve, but the leaflets remained with minimum damage. Aortic valve replacement, direct closure of the patent foramen ovale, and simple resection of the vegetation were performed. The postoperative course was uneventful.