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Year : 2015  |  Volume : 5  |  Issue : 1  |  Page : 21-23

Ventricular septal defect and bivalvular endocarditis

1 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
2 Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
3 Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA

Correspondence Address:
Lori A Blauwet
Mayo Clinic, 200 First Street SW, Rochester, MN 55905
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-0770.148507

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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.

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