A Rare Case of Isolated Native Pulmonic Valve Infective Endocarditis Revealed by Septic Pulmonary Embolism: A Case Report and Literature Review

Abstract

Isolated pulmonic valve infective endocarditis is an exceptionally rare clinical entity, particularly in the absence of traditional predisposing risk factors, and remains diagnostically challenging because of its non-specific clinical presentation. We report the case of a 73-year-old patient with a history of Charcot–Marie–Tooth disease who presented with febrile dyspnoea. Thoracic computed tomography revealed bilateral septic pulmonary emboli without evidence of right-heart strain. Transthoracic echocardiography demonstrated large vegetations on the native pulmonic valve, associated with moderate pulmonary regurgitation, while blood cultures grew Streptococcus gallolyticus. The patient received targeted intravenous antibiotic therapy. Following evaluation by the Heart Team, surgical intervention was not considered indicated, and medical management alone resulted in a favourable outcome. This case illustrates that isolated pulmonic valve infective endocarditis may present as septic pulmonary embolism in the absence of conventional risk factors and emphasises the importance of meticulous transthoracic echocardiographic assessment whenever clinical suspicion arises, even in atypical presentations. Early recognition is essential for establishing the diagnosis promptly, guiding appropriate management, and potentially enabling successful conservative treatment in selected patients.