Jeedigunta Mahidhar, R Padmakumar, Prabhu Mukhyaprana, M V Ashwini
Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Department of Cardiovascular Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India.
Case Rep Med. 2025 Aug 22;2025:6648360. doi: 10.1155/carm/6648360. eCollection 2025.
Infective endocarditis is a devastating disease with high morbidity and mortality. Infective endocarditis affecting all four valves is rarely encountered. Even rarer is the involvement of all four valves by nutritionally variant streptococci, . The case describes a female in her 40s, known case of small perimembranous ventricular septal defect, who presented with symptoms of fever and congestive cardiac failure, with severe anemia, glomerulonephritis, and pain abdomen, who was found to have vegetations on pulmonary, tricuspid, mitral, and aortic valves, with pulmonary regurgitation, tricuspid regurgitation, mitral, and aortic regurgitations. Blood culture grew species. She improved clinically after intravenous antibiotics, decongestive measures, and blood transfusion. Causation of quadrivalvular infective endocarditis is rare and previously has not been documented in infection, a fastidious species. Interestingly, the patient remained quite stable despite involvement of all four heart valves, likely due to the predominant involvement of the pulmonary valve. This case report discusses the factors predisposing to infective endocarditis in a known case of congenital heart disease and the importance of timely diagnosis and treatment.
感染性心内膜炎是一种具有高发病率和死亡率的严重疾病。累及所有四个瓣膜的感染性心内膜炎很少见。营养变异型链球菌累及所有四个瓣膜的情况更为罕见。该病例描述了一名40多岁的女性，已知患有小型膜周部室间隔缺损，出现发热和充血性心力衰竭症状，伴有严重贫血、肾小球肾炎和腹痛，发现其肺动脉瓣、三尖瓣、二尖瓣和主动脉瓣上有赘生物，伴有肺动脉反流、三尖瓣反流、二尖瓣反流和主动脉反流。血培养培养出[具体菌种]。经静脉抗生素治疗、减轻充血措施和输血后，她的临床症状有所改善。四瓣膜感染性心内膜炎的病因罕见，此前在[具体菌种]感染（一种苛求菌）中尚未有记载。有趣的是，尽管所有四个心脏瓣膜均受累，但患者仍相当稳定，这可能是由于肺动脉瓣受累为主。本病例报告讨论了先天性心脏病已知病例中易患感染性心内膜炎的因素以及及时诊断和治疗的重要性。
