# Recurrent isolated pulmonic valve infective endocarditis in a patient on chronic haemodialysis due to reinfection: description of an index case and management considerations

## TL;DR

This paper reports a rare case of recurrent pulmonic valve infective endocarditis in a patient on chronic hemodialysis and discusses its management.

## Contribution

The paper presents a unique case of recurrent isolated pulmonic valve infective endocarditis in a hemodialysis patient, highlighting diagnostic and management challenges.

## Key findings

- A 32-year-old male on chronic hemodialysis experienced recurrent pulmonic valve infective endocarditis caused by methicillin-sensitive S. aureus.
- The patient had new septic emboli and peri-graft fluid collection, which was managed with valve explantation and negative follow-up cultures.
- The case highlights the unique pathology and management considerations for recurrent isolated PVIE in hemodialysis patients.

## Abstract

Right-sided infective endocarditis is uncommon, and isolated pulmonic valve infective endocarditis (PVIE) is rare. Chronic haemodialysis is a risk factor for developing infective endocarditis. but recurrent PVIE in this population is not well described.

A 32-year-old male with end-stage renal disease on chronic haemodialysis and diagnosed with PVIE 6 months back due to Staphylococcus epidermidis without identified source of infection presented again with recurrent PVIE with methicillin sensitive S. aureus, new pulmonic septic emboli, and peri-graft fluid collection on imaging, which was explanted with negative follow-up culture.

Through this index case, we describe the unique pathology of recurrent isolated PVIE and explore its diagnostic and management considerations.