Endocarditis complicating parenteral nutrition: the value of repeated echocardiography

Endocarditis with a large thrombus complicating a central venous access device

A 12-month-old child on total parenteral nutrition via a central venous access device developed an infected thrombus and endocarditis. The vegetation disappeared on conservative management. The device was left in place.

Isolated pulmonary valve endocarditis: a rare or an underdiagnosed disease?

A 48 year old patient with resistant coeliac disease developed prolonged unexplained pyrexia after surgery for small bowel volvulus. Despite extensive investigations and intensive antibiotic therapy, he deteriorated and died eight weeks postoperatively and significant isolated pulmonary valve endocarditis was discovered at autopsy. This diagnosis should be considered in all critically ill patients with unexplained pyrexia even in the absence of clinical features of endocarditis and transoesophageal echocardiography performed to exclude or confirm this lesion.