A 39-year-old man was admitted for a febrile congestive heart failure. Echocardiography revealed large vegetations on the mitral and aortic valves associated to a large mobile vegetation attached to the left ventricular outflow wall. Three days after the initiation of an intensive medical and antibiotic therapy, he underwent a double prosthetic valve replacement because of massive mitral regurgitation with cardiac heart failure. Culture of the vegetations identified a streptococcus. Long term outcome was uneventful. Bacterial inoculation of the parietal endocardium in valvular endocarditis is extremely rare and was probably due to lesions caused by previous regurgitation in our patient.
Z Ibn Elhadj, M Boukhris, I Kammoun, A Ben Halima, Double Site Left Heart Endocarditis With Ventricular Outflow Tract Mural Vegetation Journal of the Hong Kong College of Cardiology 2014;22(1) https://doi.org/10.55503/2790-6744.1028