A 14-year-old boy with an uneventful past history suffered from one week of high-grade fever and progressive dyspnea. The patient developed necrotizing pneumonia with massive loculated pleural effusion and septic shock. Echocardiogram revealed a small perimembranous VSD with multiple vegetations at pulmonic valve and both pulmonary arteries. Intravenous antibiotic therapy, mechanical ventilatory support, chest tube placement, and intrapleural fibrinolytic therapy were performed. He was clinically improved after eight weeks of antibiotic therapy.

Keywords: Septic pulmonary embolism; Pulmonic valve endocarditis; Infective endocarditis

DOI: 10.35755/jmedassocthai.2024.1.13937

Received 18 September 2023 | Revised 10 January 2024 | Accepted 12 January 2024