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Pulmonic Valve Repair in a Patient with Isolated Pulmonic Valve Endocarditis and Sickle Cell Disease.

Glew T, Feliciano M, Finkielstein D, Hecht S, Hoffman D - Case Rep Cardiol (2015)

Bottom Line: A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter.In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion.Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Mount Sinai Beth Israel, New York, NY 10003, USA.

ABSTRACT
A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter. Chest computerized tomography showed multiple bilateral pulmonary nodular opacities consistent with septic emboli. Transthoracic and transesophageal echocardiograms revealed a large echodensity on the pulmonic valve requiring vegetation excision and pulmonic valve repair. In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion. Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.

No MeSH data available.


Related in: MedlinePlus

Transthoracic echocardiogram parasternal short axis showing a 2.2 × 1.31 cm echodensity on the pulmonic valve.
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fig1: Transthoracic echocardiogram parasternal short axis showing a 2.2 × 1.31 cm echodensity on the pulmonic valve.

Mentions: On admission to our hospital she was afebrile and had a previously undocumented 2/6 diastolic murmur over the pulmonary area, a leukocyte count of 15,900 cells/mm3, and 75% neutrophils. A TTE was obtained which showed large vegetation on the pulmonic valve (2.3 × 1.3 cm) and trace pulmonic regurgitation (Figures 1(a) and 1(b)). She was continued on vancomycin and rifampin and repeat blood cultures were negative. Given the large size of the vegetation a transesophageal echocardiogram (TEE) was obtained for potential surgical planning. The TEE revealed a 2.4 × 1.8 cm echogenic mobile mass on the pulmonic valve, trace pulmonic regurgitation, and no other significant valvular pathology (Figures 2(a) and 2(b)).


Pulmonic Valve Repair in a Patient with Isolated Pulmonic Valve Endocarditis and Sickle Cell Disease.

Glew T, Feliciano M, Finkielstein D, Hecht S, Hoffman D - Case Rep Cardiol (2015)

Transthoracic echocardiogram parasternal short axis showing a 2.2 × 1.31 cm echodensity on the pulmonic valve.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493266&req=5

fig1: Transthoracic echocardiogram parasternal short axis showing a 2.2 × 1.31 cm echodensity on the pulmonic valve.
Mentions: On admission to our hospital she was afebrile and had a previously undocumented 2/6 diastolic murmur over the pulmonary area, a leukocyte count of 15,900 cells/mm3, and 75% neutrophils. A TTE was obtained which showed large vegetation on the pulmonic valve (2.3 × 1.3 cm) and trace pulmonic regurgitation (Figures 1(a) and 1(b)). She was continued on vancomycin and rifampin and repeat blood cultures were negative. Given the large size of the vegetation a transesophageal echocardiogram (TEE) was obtained for potential surgical planning. The TEE revealed a 2.4 × 1.8 cm echogenic mobile mass on the pulmonic valve, trace pulmonic regurgitation, and no other significant valvular pathology (Figures 2(a) and 2(b)).

Bottom Line: A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter.In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion.Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Mount Sinai Beth Israel, New York, NY 10003, USA.

ABSTRACT
A 49-year-old woman with sickle cell disease presented with one month of exertional dyspnea, weakness, and fever and was diagnosed with isolated pulmonic valve endocarditis secondary to methicillin-resistant Staphylococcus bacteremia in the setting of a peripherally inserted central venous catheter. Chest computerized tomography showed multiple bilateral pulmonary nodular opacities consistent with septic emboli. Transthoracic and transesophageal echocardiograms revealed a large echodensity on the pulmonic valve requiring vegetation excision and pulmonic valve repair. In conclusion, isolated pulmonic valve endocarditis is a rare cause of infective endocarditis that warrants a high index of clinical suspicion. Furthermore the management of patients with sickle cell disease and endocarditis requires special consideration.

No MeSH data available.


Related in: MedlinePlus