Pulmonary valve endocarditis with septic pulmonary thromboembolism in a patient with ventricular septal defect.

We describe a 42-year-old man who presented as life-threatening sepsis and septic shock with multiple septic pulmonary embolism and septic pneumonia due to pulmonary valve endocarditis. The patient had history of untreated ventricular septal defect (VSD) and complained of severe dyspnea and orthopnea. Transthoracic and transesophageal echocardiograms revealed severe pulmonary regurgitation with large, hypermobile vegetation on pulmonary valve and right ventricular outflow tract (RVOT), and a small subarterial type VSD. Emergency operation was done due to rapid deterioration of the patient, and after 6 weeks of antibiotics coverage, he was discharged.