Isolated pulmonic valve endocarditis in healthy hearts: a case report and review of the literature.

The case of a 53-year-old man with isolated pulmonic valve endocarditis in a structurally normal heart is presented. The patient had a history of chronic obstructive pulmonary disease and was admitted to hospital with an apparent exacerbation with pneumonia. Blood cultures grew Staphylococcus aureus, and an echocardiogram identified a large vegetation on the pulmonic valve in a structurally normal heart. He was unsuccessfully treated with antibiotics and eventually required pulmonic valve replacement. The literature from 1960 to 1999 identified only 36 reported cases of pulmonic valve endocarditis in structurally normal hearts. The present report underscores the importance of suspecting pulmonic valve endocarditis in patients with multiple pulmonary lesions, and discusses the predisposing factors, clinical features, diagnostic role of echocardiography and the potential benefits of early surgical treatment.