Parekh Sneh, Loyola Guillermo, Caldas Ricardo A, Choudhry Hamza, Griffith Emma M
Department of Internal Medicine, University of Florida, College of Medicine, Jacksonville, FL, USA.
Am J Case Rep. 2025 Aug 13;26:e948820. doi: 10.12659/AJCR.948820.
BACKGROUND We present a rare case of pulmonic valve endocarditis complicated by septic pulmonary embolism and pulmonary edema due to Staphylococcus haemolyticus in a patient without risk factors such as indwelling catheters, implanted devices, or intravenous drug use. Pulmonic valve endocarditis is itself a rare entity, comprising less than 2% of all cases of infective endocarditis; a mere 70 reports of isolated pulmonic valve infective endocarditis are reflected in the literature between 1979 and 2013. Diagnosis requires blood cultures and echocardiography, with intravenous antibiotics the method of treatment, similar to other types of infective endocarditis. CASE REPORT This case report details a 31-year-old man with no relevant past medical history presenting with a 3-month history of fever, chills, and night sweats. He was eventually diagnosed with pulmonic valve endocarditis from Staphylococcus haemolyticus through echocardiography and was treated with antibiotics and valve replacement. In this case, we also present a discussion of the literature on the diagnosis and management of pulmonic valve endocarditis, due to its rarity in nature. CONCLUSIONS Pulmonic valve endocarditis often presents insidiously, without the presence of risk factors, such as intravenous drug use, as in this case. Such atypical presentations pose a significant diagnostic challenge and may lead to delays in treatment with concurrently increased risk of mortality. It is important to use the Duke criteria to formally diagnose infective endocarditis, along with echocardiography for characterization, thus allowing for effective and prompt management.
背景 我们报告一例罕见的肺瓣膜心内膜炎病例，该病例由溶血葡萄球菌引起，并发感染性肺栓塞和肺水肿，患者无诸如留置导管、植入装置或静脉吸毒等危险因素。肺瓣膜心内膜炎本身就是一种罕见疾病，占所有感染性心内膜炎病例的比例不到2%；1979年至2013年期间的文献中仅反映了70例孤立性肺瓣膜感染性心内膜炎的报告。诊断需要进行血培养和超声心动图检查，治疗方法为静脉使用抗生素，这与其他类型的感染性心内膜炎相似。病例报告 本病例报告详细介绍了一名31岁男性，既往无相关病史，有3个月的发热、寒战和盗汗病史。他最终通过超声心动图被诊断为溶血葡萄球菌引起的肺瓣膜心内膜炎，并接受了抗生素治疗和瓣膜置换。在本病例中，由于肺瓣膜心内膜炎本质上较为罕见，我们还对其诊断和治疗的文献进行了讨论。结论 肺瓣膜心内膜炎通常隐匿起病，如本病例所示，不存在诸如静脉吸毒等危险因素。这种非典型表现构成了重大的诊断挑战，可能导致治疗延迟，同时增加死亡风险。使用杜克标准正式诊断感染性心内膜炎，并结合超声心动图进行特征描述，从而实现有效和及时的管理，这一点很重要。
