Pulmonary endarteritis and endocarditis complicated with septic embolism: a case report and review of the literature.

BACKGROUND: Pulmonary endarteritis is a rare clinical phenomenon with congenital heart that can potentially lead to major complications. CASE PRESENTATION: We report a 47-year-old man with pulmonary endarteritis. This patient presented with hypertension, chest pain and a previous history of pulmonary valve disease during childhood. Also, eight-months prior, he was hospitalized with dyspnea (Functional Class III), cough, phlegm, and night sweats without fever. Echocardiographic diagnosis in the first transtransthoracic echocardiography (TTE) was intense pulmonary valve stenosis (PVS) an, thus, the pulmonary valve vegetation and PVS, established by transesophageal echocardiography (TEE). He was referred for surgery after 1 weeks of intravenous antibiotic therapy for removal of the vegetation. CONCLUSIONS: Finally he was asymptomatic at 3-months of follow-up and was clinically in good condition. Therefore, the detection of infective endocarditis of the lung valve must not lengthy be prolonged.

Pulmonary endarteritis in a patient with patent ductus arteriosus and a bicuspid aortic valve

BACKGROUND: Infective endarteritis of the pulmonary artery is an unusual event. While congenital heart disease (CHD) is a risk factor, pulmonary endarteritis as a complication is a rare occurrence especially in the era of antibiotic therapy.CASE PRESENTATION: We present a case of a 43-year-old female who initially sought consultation due to fever. Physical examination revealed a continuous murmur at the second intercostal space left parasternal border. There was no petechiae or any other skin lesions noted. Transthoracic two dimensional echocardiogram showed eccentric left ventricular hypertrophy with an ejection fraction of 65%. She had a patent ductus arterioscus as well as a bicuspid aortic valve. Further interrogation revealed a vegetation at the main pulmonary artery. Patient was initially started on ceftriaxone and gentamycin. Blood cultures were positive for coagulase negative Staphylococcus aureus. Ceftriaxone was then shifted to vancomycin, which was completed for 28 days.OUTCOME: Clinical improvement was accompanied by the disappearance of the vegetation and negative blood cultures. Patient was maintained on enalapril and advised closure of the patent ductus arteriosus. She opted medical management for the time being and was discharge stable and improved.CONCLUSION: Pulmonary endarteritis is an uncommon complication of CHD. A high index of suspicion must prompt careful evaluation, combining clinical, laboratory and echocardiographic modalitites in order to provide early diagnosis and effective treatment.

Pulmonary endarteritis, cerebral abscesses, and a single ventricle: An uncommon combination.

Endocarditis of the right side of the heart is otherwise uncommon in children. Pulmonary endarteritis as a complication of congenital heart disease is even rarer. Herein, we report the case of pulmonary endarteritis with a 7 mm ×5 mm vegetation, involving the main pulmonary artery in a 4-year-old male child, with cyanosis and a 1-week history of fever and rapidly-progressive hemiparesis. A full segmental echocardiography demonstrated a double inlet left ventricle with left-sided subaortic hypoplastic right ventricle (Van Praagh's A-III type - Single Ventricle). Additionally, CT scan of the brain revealed bilateral cerebral abscesses. To the best of our knowledge, the occurrence of pulmonary endarteritis and cerebral abscesses in a case of single ventricle is hitherto unreported. This article underlines the importance of heightened clinical awareness and meticulous echocardiography in cases of congenital heart disease so that relatively rare complications may not be missed.

Large patent ductus arteriosus in an adult complicated by pulmonary endarteritis and embolic lung abscess.

Patent ductus arteriosus in the adult is an extremely rare clinical phenomenon. We report the case of a 34-year old man who developed pulmonary endarteritis and subsequent embolic lung abscess secondary to a large patent ductus arteriosus. This brief report also provides an overview of the natural history, potential complications, optimal therapy, and diagnostic dilemmas associated with this persistent congenital cardiac defect in adults.

A Case of Pulmonary Artery Endarteritis due to Staphylococcus lugdunensis in Patient with Clinically Silent Patent Ductus Arteriosus / 이화의대지

Staphylococcus lugdunensis (S. lugdunensis) is an unusually virulent coagulase-negative staphylococci (CNS) and uncommon cause of infective endocarditis (IE) involving mainly native left sided valves. S. lugdunensis IE, which was described previously as "surreptitious" and "wolf in sheep's clothing", runs an aggressive course with a high rate of severe in-hospital complications. Therefore, early surgical treatment has been considered for the treatment of S. lugdunensis IE. However, we experienced a case of S. lugdunensis pulmonary endarteritis which was cured with antibiotic therapy alone.