title: Ventricular septal defect and bivalvular endocarditis.
abstract: A 63-year-old man presented with generalized fatigue, chills, malaise, dyspnea, intermittent fevers, and 50-pound weight loss of 4 months' duration. Blood cultures were positive for pan-sensitive Streptococcus anginosus. Transesophageal echocardiography showed an 11 mm × 3 mm mobile mass attached to the mitral valve, a 16 mm × 16 mm mobile mass attached to the pulmonary valve, and a small membranous ventricular septal defect. The patient received 12 weeks of intravenous (IV) antibiotics with eventual resolution of the masses. Multi-valve endocarditis involving both the left and right chambers is rarely reported without prior history of IV drug use or infective endocarditis. Our case emphasizes the importance of careful assessment for ventricular septal defects or extra-cardiac shunts in individuals who present with simultaneous right and left-sided endocarditis.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Birkenkamp
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Jin
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Raina
authors.initials: R
authors.lastname: Shivashankar
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Hayan
authors.initials: H
authors.lastname: Jouni
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Larry M
authors.initials: LM
authors.lastname: Baddour
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Blauwet
keywords: Echocardiography; infective endocarditis; pulmonary valve endocarditis; ventricular septal defect