Isolated pulmonary valve endocarditis in a 7-year-old Nigerian girl: a case report

Abstract

BACKGROUND: Right-sided infective endocarditis is a rare clinical entity, with isolated pulmonary valve infective endocarditis being extremely uncommon. Infective endocarditis carries a high mortality rate and significant complications, making early identification and prompt management crucial in improving outcomes. This case highlights an unusual presentation of right-sided infective endocarditis isolated to the pulmonic valve in a pediatric patient with no apparent preexisting heart disease. CASE PRESENTATION: A 7-year-old girl of Yoruba ethnicity presented with septicemic illness, congestive heart failure, and no evidence of congenital cardiac lesion, underlying valvular disease, or identifiable predisposing factors. She had underweight malnutrition, cachexia, and severe respiratory distress. Echocardiography, which was delayed due to resource limitations, ultimately revealed isolated myxomatous vegetation on the pulmonary valve, dilated right cardiac chambers, and pulmonary hypertension. Blood cultures grew Pseudomonas aeruginosa. The patient was managed with antimicrobial agents, an anticardiac failure regimen, antiplatelets, and supportive therapy. Management was complicated by financial constraints, which delayed optimal intervention. CONCLUSION: Although isolated pulmonary valve infective endocarditis is rare in the pediatric population, particularly in the absence of identifiable heart disease, a high index of suspicion is essential. Early diagnosis via echocardiography and prompt, adequate treatment are crucial for favorable outcomes. Awareness of potential diagnostic delays and financial barriers can aid in optimizing timely intervention and improving prognosis.