Pulmonary Valve Endocarditis Associated with Ventricular Septal Defect in an Infant

A 2.5 year old male infant who had a ventricular septal defect and mild pulmonary stenosis was admitted for evaluation of fever and anemic complexion in February 1995. After admission, echo cardiography revealed massive vegetations from the outflow of the right ventricle to the right pulmonary artery through the pulmonary valve, and serial blood cultures were found to be positive for streptococcus mitis. Antibiotics did not relieve the high fever or decrease the volume of vegetation in the patient. At surgery, performed 2 weeks after the admission, the pulmonary valve was entirely destroyed and it was resected without prosthetic replacement after the excision of the vegetation and a Teflon patch was used for VSD closure. The post-operative course produced no noticeable complications. In the follow-up echocardiographic study, no vegetation was observed.