Native valve endocarditis

Case submitted by Nazim Coskun

46-year-old male

No known comorbidities. Had ischemic stroke 1 week ago.

TTE and TEE were suboptimal due to noncooperation. No typical signs of vegetation.

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Selected slices showing focal area of uptake corresponding to the mitral valve (SUVmax: 4.7).

Case Notes

  • Clinical diagnosis of infective endocarditis is based on demonstration of either microbiological agent or myocardial involvement. 18F-FDG PET/CT can identify infection of valves, paravalvular areas and extracardiac sites.
  • The sensitivity of PET is lower for native valve endocarditis, compared to prosthetic valves; possibly due to fibrosis in native valves .
  • The 2023 Duke-ISCVID Criteria adds PET positivity seen within 3 months after surgery as a minor criterion, and as a minor major criterion after that .

Updated on Dec 22, 2023