A Rare Case of Simultaneous Both-side Heart Valvular Infective Endocarditis on Ventricular Septal Defect

IE is a rare pathology with an annual incidence of approximately 10 cases/100,000 inhabitants and in spite of staphylococci pathogens, streptococci are the most involved pathogens, acute articular rheumatism remains the most frequent etiology in developing countries. It can attack a healthy heart, but most often seen in a diseased heart. The incidence of bilateral right and left heart IE is significantly lower, accounting for 56% to 10% of all IE cases. Only few cases of bilateral IE on the native valve have been found in the literature. Echocardiography, whether transthoracic (TTE) or transesophageal (TOE), is a crucial examination in the management and follow-up of any IE. Vegetations are the specific lesions of endocarditis. The authors report a case of a multiple native heart valvular infective endocarditis simultaneously attacking the left and right-sides heart valves confirmed by transthoracic echocardiography and cultures in a patient poorly followed-up for non-cyanotic congenital heart disease without hemodynamic impact, diagnosed with chronic kidney disease undergoing hemodialysis on a jugular catheter. A coupled medical and surgical treatment was conducted in the patient with a very satisfying clinical outcome and less complications after an open-heart intervention.