• Toshio Doi, Takayuki Gyoten, Kimimasa Sakata, Saori Nagura, Akio Yamashita, Kazuaki Fukahara, Keiju Kotoh, and Naoki Yoshimura.
• Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Japan.
• Kyobu Geka. 2016 Jul 1; 69 (7): 537-40.

AbstractIsolated pulmonary valve endocarditis is an extremely rare clinical condition. Here, we report a case of pulmonary valve endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA). An 84-year-old man with a history of aortic regurgitation and patent foramen ovale was admitted to our hospital due to fever of unknown origin for 4 weeks' duration. MRSA was detected in his blood cultures. Transthoracic echocardiography demonstrated a mobile vegetation attached to the pulmonary valve, moderate to severe aortic regurgitation, and patent foramen ovale with left-to-right shunt. After 30-days' treatment with vancomycin, gentamicin and rifampicin, he defervesced and blood cultures became negative. At surgery, a large vegetation was still attached to the pulmonary valve, but the leaflets remained with minimum damage. Aortic valve replacement, direct closure of the patent foramen ovale, and simple resection of the vegetation were performed. The postoperative course was uneventful.

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