Key result
Pulmonary valve replacement successfully treats isolated pulmonary valve endocarditis and annular abscess in Noonan syndrome.
Why the study?
Isolated pulmonic valve endocarditis without tricuspid valve involvement is extremely rare, with limited published data posing challenges for prompt diagnosis and timely management.
Case Report (n=1)
No
Isolated pulmonary valve endocarditis is a rare condition that can be complicated by annular abscess, necessitating surgical intervention such as pulmonary valve replacement when medical therapy fails.
Supports consideration of valve replacement for rare isolated pulmonary endocarditis with abscess; leaves open generalizability in Noonan syndrome.
Right-sided endocarditis is a rare entity, with various series reporting an incidence of 5%-10%. Pulmonary valve (PV) is not only the least commonly involved valve in infective endocarditis (IE), with an incidence of 1.5%-2%, but 'isolated' pulmonic valve endocarditis (PVE) without tricuspid valve involvement is even rarer with limited published data. We report a middle-aged man with Noonan syndrome and a dysplastic PV with severe pulmonary stenosis. He presented with a large isolated mobile PV vegetation with moderate pulmonary regurgitation (PR). Initially, he was managed conservatively, but due to persistent fever, pulmonary regurgitation and evidence of pulmonary annular abscess extending into the right ventricular outflow tract, he required surgical intervention. Considering the low incidence of isolated PVE, it poses a challenge for physicians in prompt diagnosis and timely management of the infection.
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Rao et al. (2023) conducted a case report in Isolated pulmonary valve endocarditis with pulmonary annular abscess in Noonan syndrome (n=1). Pulmonary valve replacement and intravenous antibiotics was evaluated. A 50-year-old man with Noonan syndrome and isolated pulmonary valve endocarditis complicated by a pulmonary annular abscess was successfully treated with pulmonary valve replacement.
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