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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.

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  • Publisher Full Text
  • Authors

    Nishanth KR, Seshadri S, Pandit V, Krishnanand N

    Institution

    Department of General Medicine, Kasturba Medical College, Manipal, Karnataka, India. kr.nishanth@gmail.com

    Source

    BMJ case reports 2013: 2013 pg

    MeSH

    Adult
    Anemia, Aplastic
    Anti-Bacterial Agents
    Diagnosis, Differential
    Endocarditis, Bacterial
    Enterococcus faecalis
    Female
    Humans
    Pulmonary Valve

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    23483061