Infective Endocarditis in Patient With Uncorrected Patent Ductus Arteriosus: A Case Report From Rural India

A congenital cardiac defect with an untreated left-to-right shunt is a risk factor for infective endocarditis (IE), particularly right-sided infective endocarditis, which has a distinct clinical presentation and outcomes in comparison to left-sided IE. With a prevalence of at least 2-4 per 1000 term births, patent ductus arteriosus (PDA) accounts for around 10% of all congenital cardiac diseases. Early diagnosis by transthoracic echocardiography and prompt antimicrobial therapy for IE are advised to minimize multiorgan failure and severe pulmonary embolism. Closure of large, hemodynamically significant PDA could have a minimal level of intervention, and it may be done cautiously and efficiently with either surgical or transcatheter procedures. The elimination or minimization of these malformations has been advised to remove or decrease the possibility of IE. We present a case of a 10 years old female who presented with a history of intermittent fevers over two weeks. Clinical examination revealed a PDA murmur. Transthoracic echocardiology (TTE) revealed a PDA with vegetation suggestive of IE. The patient was treated with antibiotics, and two weeks after the antibiotic therapy, a TTE showed resolution of the vegetation. Thereafter, the patient was advised to undergo surgical correction of the PDA. This case report highlights the importance of the association of IE with congenital heart disease.