Prosthetic pulmonary valve endocarditis in repaired TOF
The following case has been published in the Journal of the Association of Physicians of India.

A 25-year-old male, presented with one-month history of fever associated with 15 days history of Vomiting and pain abdomen. On examination, there was a presence of Pansystolic murmur in Tricuspid area with ejection Systolic Murmur and early Diastolic murmur in the pulmonary area with splenomegaly.

He was a known case of Cyanotic congenital heart disease (Tetralogy of Fallot). The patient had undergone Pulmonary valve replacement (Bioprosthetic) in 2012 due to development of free pulmonary regurgitation. Subsequently He developed early prosthetic valve fungal endocarditis. He was managed with I/V antifungals and fever subsided.

Patient underwent echocardiographic examination which revealed vegetation attached to prosthetic pulmonary valve (Figure 1) and pulmonary regurgitation. Blood culture was positive for fungus Candida Albicans. Diagnosis of the prosthetic pulmonary valve endocarditis was made.

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