title: Septic pulmonary and systemic embolism in tricuspid endocarditis.
abstract: A 28-year-old woman presenting with fever was referred to our hospital and diagnosed as septic pulmonary embolism secondary to tricuspid valve endocarditis. Although antibiotic therapy was initiated, she further showed multiple complications including Janeway lesions and cerebral infarctions, suggestive of septic systemic embolism. Transoesophageal echocardiography detected a right-to-left shunt through a patent foramen ovale (PFO). The patient was successfully treated with surgical tricuspid valvuloplasty and PFO closure. Paradoxical systemic embolism may occur in patients with septic pulmonary embolism through the PFO.
authors.affiliation: Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Nii
authors.affiliation: Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Yoshikawa
authors.affiliation: Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Okabe
authors.affiliation: Department of Medicine, Nissay Hospital, Nippon Life Saiseikai Public Interest Incorporated Foundation, Osaka, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Tachibana
mesh_terms: D000328:Adult; D004617:Embolism / Q000175:diagnosis / Q000382:microbiology*; D019320:Embolism, Paradoxical / Q000175:diagnosis / Q000382:microbiology*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications* / Q000175:diagnosis; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis; D014261:Tricuspid Valve / Q000382:microbiology*