Right-sided Infective Endocarditis with Unknown Ventricular Septal Defect in Adult Complicated by Septic Pulmonary Emboli and Acute Renal Failure: Case Report

Introduction: Right-sided infective endocarditis (IE) accounts for 5-10% of all cases of IE. Compared with left sided IE and the association of right heart endocarditis with ventricular septal defect in adults is rare but may have serious complications such as pulmonary embolism. its antibiotic treatment is more effective. Therefore, the timing of its surgical treatment is still controversial.

Case Presentation: We present the case of a 21-year-old male patient with no previous medical history who was admitted to our department. The patient's admission was due to right-sided Staphylococcus aureus endocarditis, which was complicated by acute renal failure and haemoptysis resulting from multiple pulmonary emboli. Of note, there was an unidentified ventricular septal defect associated with the condition.TTE showed a large left‐to‐right shunt subaortic VSD and multiple vegetations were attached to the anterior leaflet, on the septal leaflet, and on the posterior leaflet and another vegetation attached to the chordae tendineae.Despite continuous antibiotic treatment, the vegetations still remained we decided to perform surgical treatment, vegetectomy, tricuspid valve plasty and VSD patch closure.

Conclusion: Patients with undiagnosed congenital ventricular septal defects are considered to be at a heightened risk for developing infective endocarditis. As a preventive measure, it is strongly recommended to administer prophylaxis for endocarditis following dental procedures and/or in cases of soft tissue infections. This approach aims to reduce the likelihood of bacterial infection reaching the heart and causing endocarditis.