title: Isolated pulmonary valve endocarditis in a patient with aplastic anaemia.
abstract: A 42-year-old female patient of aplastic anaemia on maintenance blood transfusion presented with a 3-week history of fever, cough, dyspnoea and pedal oedema. Upon examination she  was found to have severe pallor, temperature of 101°F, tachycardia, bilateral pitting pedal oedema, raised jugular venous pressure, ejection systolic murmur (grade 2/6) in pulmonary area and petechiae over extensor aspect of both lower limbs. Blood investigations revealed low haemoglobin, thrombocytopaenia and mild increase in serum creatine. Chest x-ray was normal. Initial 2D trans thoracic echocardiography performed after hospital admission was normal. Antibiotics were started empirically to treat a possible underlying infection. Subsequently, three sets of blood cultures grew Enterococcus faecalis. Upon searching for the source, repeat echocardiograph done showed 2×0.5 cm vegetation on both pulmonary leaflets with severe pulmonary regurgitation, all other valves were free of vegetations. She was treated with intravenous antibiotics for the endocarditis and improved.
authors.affiliation: Department of General Medicine, Kasturba Medical College, Manipal, Karnataka, India. kr.nishanth@gmail.com
authors.forename: K R
authors.initials: KR
authors.lastname: Nishanth
authors.forename: Shubha
authors.initials: S
authors.lastname: Seshadri
authors.forename: Vinay
authors.initials: V
authors.lastname: Pandit
authors.forename: N
authors.initials: N
authors.lastname: Krishnanand
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology*; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D011664:Pulmonary Valve / Q000382:microbiology*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents