ISOLATED PULMONARY VALVE ENDOCARDITIS - A RARE OR AN UNDERDIAGNOSED DISEASE

A 48 year old patient with resistant coeliac disease developed prolong ed unexplained pyrexia after surgery for small bowel volvulus. Despite extensive investigations and intensive antibiotic therapy, he deterio rated and died eight weeks postoperatively and significant isolated pu lmonary valve endocarditis was discovered at autopsy. This diagnosis s hould be considered in all critically ill patients with unexplained py rexia even in the absence of clinical features of endocarditis and tra nsoesophageal echocardiography performed to exclude or confirm this le sion.