Nour El Houda Lamassab, El Ouafi Noha, Ismaili Nabila
Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco.
Department of Cardiology, Mohammed VI University Hospital/Mohammed I University, Oujda, Morocco.
Radiol Case Rep. 2025 Jun 24;20(9):4545-4550. doi: 10.1016/j.radcr.2025.05.082. eCollection 2025 Sep.
Isolated pulmonary valve (PV) endocarditis is an exceedingly rare entity, accounting for less than 2% of all infective endocarditis cases. Its diagnosis is often delayed due to nonspecific clinical features and the inherent difficulty in visualizing the pulmonary valve on standard transthoracic and transesophageal echocardiography. We report the case of a 43-year-old woman presenting with persistent fever and pulmonary symptoms, in whom transthoracic echocardiography revealed a mobile vegetation on the PV. Despite clear imaging, the diagnosis was initially delayed due to the low index of suspicion and the unusual location of the infection. Further investigation uncovered a silent patent ductus arteriosus (PDA), likely predisposing to endocardial seeding. This case underscores the importance of maintaining clinical vigilance for PV involvement, even in non-IV drug users, and highlights how echocardiography-when carefully interpreted-can reveal rare valvular pathology. Recognition of atypical sites of endocarditis is crucial for timely diagnosis and management.
孤立性肺动脉瓣心内膜炎是一种极为罕见的疾病，占所有感染性心内膜炎病例的比例不到2%。由于其临床特征不具特异性，且在标准经胸和经食管超声心动图检查中难以观察到肺动脉瓣，其诊断往往会延迟。我们报告了一例43岁女性患者，该患者出现持续发热和肺部症状，经胸超声心动图显示肺动脉瓣上有一个活动的赘生物。尽管影像学表现明确，但由于怀疑指数低以及感染部位不寻常，最初诊断延迟。进一步检查发现了一个无症状的动脉导管未闭（PDA），可能是心内膜感染的易感因素。该病例强调了即使在非静脉药物使用者中，对肺动脉瓣受累保持临床警惕的重要性，并突出了仔细解读超声心动图如何能够揭示罕见的瓣膜病变。认识到心内膜炎的非典型部位对于及时诊断和治疗至关重要。
